One in three GP practices in Barking and Dagenham have been ranked either ‘Inadequate’ or ‘Needs Improvement’ by the Care Quality Commission (CQC), figures show, by far the worst in the capital.
Data analysis conducted by the North East Londoner of CQC data has found that 32.4% of GPs in the borough failed to meet standards, more than four times higher than the average London borough at 7.4%.
Jenny Hadgraft, Interim Manager of Healthwatch Barking and Dagenham, whose work in using resident’s feedback to improve care is delivered by the charity Life Line Projects, said the majority of the feedback they receive is about GP practices.
Hadgraft explained: “From January to March this year, 74% of our feedback involved GP services in the borough.
“This could be feedback ranging from feeling like they’re on hold on the phone for too long, to a lack of face-to-face appointments, to a query about how to make a complaint, or it could even be as generic as they don’t know where their local GP is.”
One of the reasons Hadgraft supposed that Barking and Dagenham GPs were so poor was the levels of poverty in the borough.
She added: “Research has shown that in deprived areas, of which Barking and Dagenham is, the GPs tend to have more patients per GP than more affluent areas, and communities in deprived areas have more health problems and so pay more frequent visits to the GP.”
More than a quarter of the feedback Healthwatch Barking and Dagenham received about any medical service in the area was about issues in booking appointments.
Hadgraft said: “What we hear from people as the main gripe is that they didn’t get an emergency appointment as quickly as they like, or that they might have to wait for what they perceive to be longer than what they’d expect for a routine appointment.”
While Barking and Dagenham are firmly last place in GP rankings, there are still other boroughs lagging behind the average, with second worst going to Southwark with 18.75% of GPs ranked inadequate or needing improvement, followed by Lewisham at 16.75%.
In contrast, Hackney is at the top of the table, with 97.3% of GPs ranked ‘Good’ and the remainder ranked ‘Outstanding’, followed by City of London and Hammersmith & Fulham who both can boast 100% ‘Good’ GP rankings.
When looking at GPs across Barking and Dagenham, there does not seem to be a strong correlation between a specific ward and a particular GP rating, but rather a mixture of rankings across the borough.
While Healthwatch Barking and Dagenham pinpointed the struggle to gain appointments as being a major issue, its far from the only one - namely, the standard of care received by patients.
Joanne Ellery, a train cleaner, is less than impressed by her local GP practices since moving from Norwich to Barking and Dagenham.
When her son experienced a urinary infection, Joanne took him to two different doctors at her local GP, both of whom dismissed her concerns.
She said: “We sat there and explained it to him, and he said ‘Ohh, no, no, it's probably not even an infection, it's probably anxiety' and I said ‘Look, I know my children. He’s in pain and he's getting worse’.
“Instead of saying, well, maybe we can refer you somewhere else, he just said ‘No, go away, you'll be fine, drink lots of water, drink cranberry juice, boom'.”
Both doctors tested her son for a UTI, which came back negative and they were sent on their way and it wasn’t until Joanne visited a walk-in clinic that her son received treatment.
She added: “The test, it came out straight away with a really severe urine infection which should have been picked up - it was really bad, I mean, it’s now actually left him with a permanent issue for years.”
Joanne also noticed the subpar quality of GP practices when she set up the ‘Dagenham Community Support’ page during the pandemic as a way to support people struggling.
She said: “Just the whole COVID situation made it more apparent how bad it is around here. We helped people who weren't getting their medicines, or had received promises of things being delivered that weren't, or people running out of inhalers or insulin.
“I know COVID will be blamed for that, but surely in a crisis, medicine is the most important thing?”
Steve*, a Barking and Dagenham resident, feels that the GPs in the borough have become an unfriendly place.
He said, “Often, reception staff seem uninterested in the work they're doing.
"They're not as helpful, they're not as engaging so right from the get-go, when you step into the surgery, you feel like you're not welcome at all.
“Then when you step into the GP’s office, it's the same thing: it's just this disinterest, the rapport building is not there anymore like it used to be.
“I remember some time back we used to have very good relations with our GP and they'd ask us how we were doing, how we were going about.
"It was like a tailor-made experience for each individual patient. But as of late it's like going to see a random stranger, and you just don't get that sense of comfort anymore.”
Steve has also found himself frustrated to find that test results he’d been waiting for had gone missing, and he has had to return to chase people up.
He said: “These small things add up, and become this large problem, and I think the local community as a whole feels the same way. I don't think anyone is happy with the way things are going.”
Steve made it clear that he doesn’t blame individual staff, but rather the system they exist in.
He added: “I really appreciate what the healthcare staff are doing. It's not the people that we should be looking at, it's the policies and seeing why this is happening.
“I don't blame the staff: they’re very overworked and the services are stretched too far, too thin.
“I think that's one of the reasons that's leading them to have this inhibited state where they just want to get on with the day and see the patients as fast as possible and get through them quickly.”
When asked about the subpar performance of Barking and Dagenham GPs, a spokesperson for NHS North East London said: “CQC inspection reports provide valuable insight to help us support local GP practices to be as good as they possibly can be, so that residents can have access to safe, high-quality services wherever they live.
"All of our practices in Barking and Dagenham continue to work exceptionally hard to meet the rising and increasingly complex needs of our patients, but we recognise there is room for improvement.
"We are working closely with those practices that need to improve to ensure effective action plans are implemented to address any areas of concern as quickly as possible.
"We are also investing in upgrading telephony and appointment booking systems across the borough so people can contact their surgery more easily, developing workforce plans with our local primary care networks in areas where recruitment and retention has historically been more difficult, and supporting our GPs and practice staff to access professional training so they can expand the skills and expertise available to patients."
*name changed to protect anonymity
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