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We GPs are under immense strain because there aren’t enough of us | Letters

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The paediatrician Robin Davies is correct to identify the challenges facing general practice, but fails to identify that the single biggest obstacle is insufficient size of workforce (Letters, 6 June). During the pandemic we saw a radical reshaping of how general practice services are provided. Today, there are more ways for patients to see their GP than ever before. Face-to-face consultations must always be an option, but there are advantages for some patients in accessing remote consultation.

The Royal College of General Practitioners has put forward proposals to improve access to GPs, harness better technology and develop multidisciplinary teams. There are also ideas on the horizon from the government promising improvements. We await these innovations with optimism, but at present the profession is in a daily battle to respond to patient need and a backlog of care with insufficient infrastructure – both digital and physical.

Davies’ suggestion of a direct hotline for primary and secondary care colleagues to communicate with practices is a good idea, but it would require additional personnel, otherwise we would just be prioritising one call over another.

General practice demonstrated nimble adaptability in changing how we work. We are embracing technology while remembering the importance of relationship-based care and treating the individual needs of patients. The profession is under immense strain. We all rose to the challenge of Covid-19, but working day after day at well above capacity is not sustainable.
Dr Rowena Christmas
Chair, Royal College of General Practitioners Cymru Wales

The reason that it is hard for the public to contact their surgery is due to high demand for GP services. This has complex causes and, as a GP, I know that the situation is universally upsetting among GPs themselves. Professional contact is a separate matter – professional liaison is an essential part of all of our roles, and timeliness can be lifesaving for patients.

Most surgeries have a dedicated telephone line through which NHS professionals can contact them about patient care. Robin Davies can sign up for an account with the NHS finder service, which allows clinicians to access phone lines for primary and secondary care.
Dr Fiona MacPherson Smith
Cheltenham, Gloucestershire

As a GP, I share Robin Davies’ frustration, anxious as I am that patients are able to contact us when they need to. But the reason for long queues on the phone is the immense pressure that general practice is under. Like those in secondary care, I and my GP colleagues have never worked so intensely, regularly doing 12-hour days.

At my own practice, the number of patient contacts being dealt with by an individual doctor has never been so high, and can exceed 100 a day. It is not access that is the problem, but GP capacity, and if something isn’t done to remedy the situation quickly, the NHS will soon be beyond repair.
Dr Peter Aird
Wellington, Somerset

That Robin Davies was “number 29 in a queue” highlights the workforce crisis in primary care. There are only so many receptionists and clinicians that a GP practice can afford when they are typically funded with just £155 per patient per year to provide unlimited care.
Dr Stephen Savory
GP; chair, Lincolnshire local medical committee

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Kevin Lankinen, Predators take down Islanders 4-1

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Kevin Lankinen made a career-high 48 saves and the Nashville Predators beat the New York Islanders 4-1 on Friday night for their seventh victory in nine games.

Filip Forsberg and Roman Josi scored and Matt Duchene and Mikael Granlund added empty-net goals. The Predators have won nine straight games against the Islanders, the longest active streak against a single opponent. The Predators are 11-1-1 in their last 13 overall against the Islanders.

“Lanky knew what he was doing. We had great goaltending,’’ Forsberg said. “The reason we are happy is the play of our goaltender.”

Mathew Barzal scored for New York midway through the third period.

“That’s a good hockey team over there,’’ Barzal said of the Predators, who are 7-1-1 in their last nine games. “They are heavy and strong with good D. It could have gone either way.”

The Predators were coming off 4-3 comeback win at New Jersey on Thursday night in which they scored with nine seconds left in the third period and won 33 seconds into overtime.

“We played two solid games against two very good teams,″ said Duchene, whose goal was the 300th of his career. “The Islanders threw the kitchen sink at us in the third.”

Forsberg opened the scoring on a power play with 5:42 left in the first with his eighth goal of the season. Duchene and Josi assisted.

Josi, the Predators captain, made it 2-0 on a power play at 8:22 of the second. Forsberg and Duchene assisted.

Josi has 10 points in his last seven games against the Islanders, including four assists in Nashville’s 5-4 home Nov. 17. The Swiss-born defenseman is four points from tying David Legwand for most points (566) in Predators history.

Lankinen made nine saves in the first, 18 in the second and 21 more in the third. The 27-year-old Finnish goaltender played the previous two seasons with Chicago.

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“Kevin was great. He was really good down the stretch,’’ Predators coach John Hynes said. “It’s great to see him get rewarded.”

Islanders Lane Lambert said he was pleased with the Islanders’ offense which generated a season-high 49 shots. But Lankinen was there to stop all but one as the Islanders lost for only the fourth time in 12 home games.

“We did a good job at times,’’ Lambert said. “It was just one of those nights.”

Predators defenseman Ryan McDonagh left the game nine minutes into the third period after he was struck in the nose on a shot by Islanders defenseman Alexander Romanov. McDonagh, the former Rangers captain, wears a face shield.

The Islanders scratched forward Kyle Palmieri, who was placed on injured reserve on Thursday retroactive to Nov. 21 … The Islanders also scratched forwards Cal Clutterbuck (day-to-day with an undisclosed injury) Ross Johnston and Hudson Fasching, who was recalled from AHL Bridgeport on Thursday along with Cole Bardreau who skated in Clutterbuck’s spot on a line with Casey Cizikas and Matt Martin … The Predators scratched forwards Eeli Tolvanen and Cody Glass.

Islanders: Host Chicago on Sunday night,

Predators: At Tampa Bay on Thursday night.

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WHO estimates 90% of world have some resistance to Covid | Coronavirus

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The World Health Organization estimates that 90% of the world population now has some resistance to Covid-19, but warned that a troubling new variant could still emerge.

Gaps in vigilance were leaving the door open for a new virus variant to appear and overtake the globally dominant Omicron, the WHO director general, Tedros Adhanom Ghebreyesus, said.

“WHO estimates that at least 90% of the world’s population now has some level of immunity to Sars-CoV-2, due to prior infection or vaccination,” said Tedros, referring to the virus that causes the Covid-19 disease.

“We are much closer to being able to say that the emergency phase of the pandemic is over – but we’re not there yet,” he told reporters.

“Gaps in surveillance, testing, sequencing and vaccination are continuing to create the perfect conditions for a new variant of concern to emerge that could cause significant mortality.”

Last weekend marked one year since the organisation announced Omicron as a new variant of concern in the Covid-19 pandemic, Tedros noted.

It has since swept round the world, proving significantly more transmissible than its predecessor, Delta.

Last week, the latest real-world study of updated Covid boosters showed that new vaccines by Pfizer/BioNTech and Moderna are likely to provide better protection compared with the original shots.

The study of more than 360,000 people indicated that the boosters offer increased protection against new variants in people who have previously received up to four doses of the older vaccine.

Since their introduction to the US in September, the vaccine boosters, which contain both original and Omicron BA.4/5 coronavirus strain, provided greater benefit to younger adults aged 18-49 years that those in the older age group.

Tedros said there were now more than 500 highly transmissible Omicron sub-lineages circulating – all able to get around built-up immunity more easily, even if they tended to be less severe than previous variants.

Around the world, 6.6 million Covid deaths have been reported to the WHO, from nearly 640 million registered cases. But the UN health agency says this will be a massive undercount and unreflective of the true toll.

Tedros said more than 8,500 people were recorded as having lost their lives to Covid last week, “which is not acceptable three years into the pandemic, when we have so many tools to prevent infections and save lives”.

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Kevin Durant, Nets beat Raptors to tally fourth win in a row

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Make it four in a row and seven of their last nine.

The Nets are one of the hottest teams in basketball and moved two games above .500 with a 114-105 victory over the Toronto Raptors in front of a sellout 17,732 fans at Barclays Center on Friday night.

They led by as many as 36 points before letting the Raptors creep back into the game late in the fourth quarter.

After digging a 2-6 hole to start the season, the Nets (13-11) have pulled a complete 180. They are inching closer toward contender status, though they still have tremendous ground to cover separating themselves from the cream of the NBA crop.

And it both looks and feels different when the Nets aren’t leaning too heavily on Kevin Durant — or Kyrie Irving, as they did for unending stretches last season.

Durant’s minutes have become a point of contention in Brooklyn, as they were last year. He entered Friday’s matchup as the league’s leader in minutes, points and field goals. At age 34 and in year 15, the Nets star is averaging 37 minutes per game for the second consecutive season.

“We’ve had to play Kevin more minutes than we’ve wanted to,” head coach Jacque Vaughn said ahead of tipoff. “That’s just kind of where we are. He understands that.”

It hits different, though, when Durant has help, and it reflects on the scoreboard.

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Sharpshooter Joe Harris got hot early, scoring 11 points in the first quarter alone. After breaking out of his shooting slump to hit four out of six threes in Wednesday’s win over the Washington Wizards, Harris, who is starting in place of the injured Ben Simmons (calf strain), hit another five threes for 17 points against the Raptors on Friday.

Royce O’Neale hit a trio of timely threes, and Kyrie Irving shouldered a large chunk of the scoring load, scoring 27 points on 17 shot attempts. Veteran forward TJ Warren, in his Nets debut after missing two-plus seasons with consecutive stress fractures in his left foot, scored 10 points on 5-of-11 shooting off the bench.

And Nic Claxton added 15 points and nine rebounds, sealing the game with a putback dunk, then offensive rebound and finish that extended the Nets’ lead back to 16.

He forced Raptors coach Nick Nurse to call his second to last timeout with four minutes left in the fourth.

It was Durant’s lightest workload of the season. He still played 38 minutes but they were low impact. He only took 10 shots and finished with 17 points, nine rebounds and seven assists.

The Nets built a lead as large as 36 and watched the Raptors whittle the deficit down to as little as seven in the final minute of the fourth quarter. It wasn’t a pretty finish but nothing has come easy for the Nets this season.

They have a chance to make it five in a row on Sunday, though they’ll have to go through last year’s Eastern Conference champion Boston Celtics to get there.

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