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GPs Report Surge in Patients Struggling with Living Costs

GPs have reported a "visible increase" in the number of patients presenting with problems associated with poor diet and poverty in 2023, compared with last year. 

The Royal College of General Practitioners (RCGP) described the findings in its annual survey of the state of general practice as "worrying".

The Government said it recognised the impact of rising prices and insisted it was providing support.

In response to growing concerns from members, the College for the first time included in its tracking survey a specific question on the cost of living and the impact of poverty on patients. 

Among 1855 GP respondents, 73% reported seeing more problems linked to the cost of living, with patients "increasingly asking for support with non-medical items, including access to council services and financial advice". In addition, almost all (93%) were very or somewhat concerned that these rising numbers would impact their workload and limit their ability to provide medical care. 

GPs "Not Financial Advisers"

Professor Kamila Hawthorne, RCGP chair, said: "GPs are doctors, not financial advisers or housing officers, but we are often the first ports of call in a crisis. GPs fully understand how social factors cause health inequalities and, from there, serious problems in physical and mental health." However, GPs were "unable to offer solutions" that tackled the root of the problems, she said. 

The RCGP noted that the survey results came in the wake of a Health Foundation analysis that showed the poorest areas of the country had the fewest GPs and that their practices had relatively less funding, despite dealing with more patients with multiple and complex health conditions.

The Foundation had calculated that although practices received similar funding per patient, when adjusted to account for greater health needs in poorer areas, practices serving more deprived populations received around 7% less funding per need-adjusted registered patient than those serving less deprived populations. 

They also had fewer GPs but more practice nurses, suggesting "possible substitution of nurses for doctors in these areas".

General Practice in Deprived Areas "Under-funded and Under-doctored"

In evidence to the Commons Health and Social Care Committee last year, the Foundation told MPs: "In areas of high deprivation, general practice is under-funded and under-doctored. General practices in poorer areas are less likely to perform well on all major markers of quality."

Prof Hawthorne agreed that the cost of living crisis was exacerbated because the areas most affected received the least support to tackle it.  "Our survey results show the tangible and worrying impact that this is having on our patients' health," she said. "Our GPs witness daily the devastating health effects that the rising cost of living and spiraling deprivation is having on patients in many communities across the UK. The link between poverty and worsening health has long been established, taking a physical, emotional, and psychological toll which can result in the early development, or exacerbation, of existing multiple chronic conditions."

Many GPs across the UK were also currently seeing patients with "diseases that should have been confined to the annals of history" – malnutrition, vitamin deficiencies, and even rickets, she added.

The survey also follows a modelling study from Scotland published this week suggesting that the cost of living crisis could increase premature death rates by 6.5%.

Potential Knock-on Effects on GP Well-being

Prof Hawthorne worried too about the knock-on effect on the health and wellbeing of GPs. "We will always do our very best for all our patients, but the demand for our services is rising at the same time as we have more GPs leaving the profession than entering it, and general practice itself is now in dire need of support."

The survey findings made it "imperative" that the Government reform funding formulas to better support practices in more deprived areas, the College urged. 

The RCGP said that the patient poverty question would remain part of its annual survey and continue to be tracked over time.

Asked to comment by Medscape News UK, a Government spokesperson said: "We recognise the impact that rising prices are having and we are providing one of the largest support packages in Europe, worth £3300 on average per household - including holding down energy bills, uprating benefits in line with inflation, and delivering direct cash payments."

The Government pointed out that the Bank of England expected inflation to fall from its peak of over 11% at the end of 2022 to around 5% by the end of this year. 

Meanwhile, lower-income households could benefit from the £2 billion household support fund , though which people can get help with essential costs from their local council, and the healthy start scheme , which helps pregnant women and parents of children under 4 to buy healthy foods and get free vitamins. The current local government finance settlement makes available up to an additional £5.1 billion to councils in England in 2023-24, while the new mortgage charter aimed to help those struggling with mortgage costs.

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