Dr Matt Lee has written an opinion piece in the BMJ titled The NHS must adapt as extreme heat becomes inevitable.

In it, he warns that the NHS must be better prepared for increasingly frequent and intense heatwaves.

Urgent action

He said that without urgent action, preventable harm to patients and healthcare workers will continue.

The column draws on a DAUK survey of 1,111 NHS staff during the June heatwave.

More than two-thirds said heat had affected patient care and safety, while 83.3% described their workplace as very or dangerously hot. Almost 90% supported the introduction of a legal maximum workplace temperature for healthcare facilities.

Heatwave survey

Dr Lee explores the survey in his BMJ Leader blog titled I can no longer keep patients safe – Heatwaves and Health Workers: time for political action.

In it he highlights the survey findings and DAUK’s calls for action in its correspondence to the political leaders responsible for health in England, Wales, Scotland and Northern Ireland.

He wrote: “A failure to act will cost even more lives. 

Bold action

“We (at Doctors Association UK), and others in the healthcare community, are ready to support politicians to take bold action to keep us all safe.”

Read Dr Lee’s opinion column in the BMJ: The NHS must adapt as extreme heat becomes inevitable

Read the BMJ Leader blog: “I can no longer keep patients safe” – Heatwaves and Health Workers: time for political action

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GP Online and Pulse have both reported on our call for Yvette Cooper and Prime Minister Andy Burnham to make five commitments to healthcare.

Pulse highlighted our call for the new Government to ‘properly fund general practice to provide timely access, continuity and safe clinical decision making’.

Read the Pulse article in full.

Access requirements

GP Online, meanwhile, highlighted our call to ‘pause unfunded or unsafe access requirements until they have been independently safety tested and properly resourced’.

Read the GP Online article in full.

DAUK wrote to Cooper earlier this week to welcome her to the role and set out five priorities for healthcare.

Five commitments

• End the medical training bottleneck. Publish specialty by specialty training numbers, fund a credible expansion to meet medical school output and NHS need, and guarantee fair progression for doctors already serving the NHS, including SAS doctors and locally employed doctors.
• Guarantee doctor-led assessment where it matters most. Set national standards so that patients urgently referred by a GP, and patients with undifferentiated symptoms in hospital, are assessed by a doctor or have discharge approved by one. Non-doctor roles should complement doctors, never replace medical assessment.
• Rebuild the family doctor model. Properly fund general practice to provide timely access, continuity and safe clinical decision making. Pause unfunded or unsafe access requirements until they have been independently safety tested and properly resourced.
• Restore fair and independent medical regulation. Remove the GMC’s separate power to appeal decisions of its own tribunal, protect the independence of the MPTS and ensure independent oversight sits with the Professional Standards Authority. A regulator cannot credibly be investigator, prosecutor and appellant.
• Treat the climate and nature crisis as an urgent health crisis, ensuring health infrastructure is adapted to be safe in extreme heat by introducing enforceable maximum safe temperatures for healthcare facilities, delivering a public awareness campaign on the relationship between climate change and health, and supporting an accelerated program of decarbonisation and nature restoration for health.

Dr Matt Kneale, DAUK co-chair, said: “These are practical, deliverable reforms that would improve patient safety, retain skilled clinicians and demonstrate that the Government is listening to those delivering care every day.

“We would welcome an early meeting with you and your team to discuss how frontline clinicians can help shape and deliver this programme.”

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Dr Matt Lee said that climate change is raising the health risks associated with extreme heat.

And he renewed Doctors’ Association UK’s call for urgent investment in hospitals, GP surgeries, and healthcare settings to create safe spaces for staff and patients.

Dr Lee said: “As wildfires rage across the UK, the excess death figures from these first heatwaves have now been released. This number will continue to rise with the most recent heatwave.

Climate crisis is a health crisis

“It is clear more than ever that the climate crisis is a health crisis and governments need to act now and act with urgency.

“Hospitals and GP surgeries are not equipped to handle heat. They should be safe spaces for patients and staff, but currently pose imminent patient and staff safety risks.

“We urge politicians of all parties to come together on making hospitals and GP surgeries safe, and we welcome discussions with any politicians who are prepared to take action for patients and healthcare workers.”

“This is the latest baseline in extreme weather events. We need immediate climate adaptations in healthcare and an accelerated program of decarbonisation and nature restoration to secure a liveable future.”

Heatwave survey

Our survey of healthcare workers during June’s record-breaking heatwave highlighted the extreme temperatures NHS staff were working in. The survey found reports of dangerously high temperatures, staff being ill at work, and disruption to patient care.

DAUK wrote to health secretary James Murray with the findings and called for urgent action, including a maximum safe working temperature for hospitals and GP surgeries.

The survey continues to make headlines.

Dr Lee was invited onto Channel 5’s topical debate programme Storm & Alexis to discuss the findings and the letter.

BBC Online has also reported on the survey and our calls in its report on the current heatwave creating new pressures for NHS hospitals. The letter to the health secretary was also reported by Management in Practice.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

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DAUK is part of SOS NHS Coalition of health organisations and unions which has written to the prospective prime minister urging him to secure the long-term future of the NHS.

The letter, which has been featured in the Guardian, also asks Burnham to meet members of the coalition to listen to their experiences of the NHS and social care.

Meanwhile, DAUK GP co-lead Dr Steve Taylor has contributed to an article exploring ‘a surge in portfolio working’ among GPs.

Underemployed and unemployed GPs

GP Online has reported that two-thirds of UK doctors have portfolio careers, which combine clinical work with work in other areas such as teaching and research.

Dr Taylor said: “There’s the element of underemployed and unemployed GPs – many have been forced to look for alternatives.

“It’s also the case that the intensity of working five days a week in NHS general practice is too high.”

Dr Taylor also provided comment to GP Online on its report that half of GP workforce growth in the last financial year came from jobs created through the additional roles reimbursement scheme (ARRS).

Workforce rebalancing

He said: “There needs to be a rebalancing of the workforce, because we’ve been under-employing GPs for some time.”

Elsewhere, Dr Taylor welcomed new NHS England guidance for planned patient care which sets out what patients and carers should expect when patients are referred for non-urgent NHS care as ‘a step in the right direction’ but said it ‘doesn’t go far enough’.

Speaking to Pulse, he said: “Patients are currently left in the dark about the referral process and where they are on the journey to seeing a specialist or waiting for an investigation. This should save some time for GP practices.”

Picture credit: Andy Burnham/Facebook

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Doctors Association UK (DAUK) has written to health secretary James Murray urging the introduction of clear national standards to ensure patients referred to hospital by a GP are assessed by a doctor.

DAUK GP co-leads Dr Sarah Jacques and Dr Steve Taylor wrote to Mr Murray following coroners’ reports into the deaths of nine-year-old Dylan Cope and eight-year-old Ethan Hanson.

They were both urgently referred to hospital by their GPs with suspected appendicitis but, according to the coroners’ findings, were not assessed by a doctor after arriving at hospital.

The letter has been featured by The BMJ, Pulse and Doctors.net.uk

In it, Dr Jacques and Dr Taylor called on the government to introduce national standards requiring patients urgently referred to hospital by a GP to be assessed by a doctor.

The letter also asks to ensure that no patient with undifferentiated symptoms is assessed or discharged without doctor oversight.

DAUK has invited Mr Murray and Department of Health officials to discuss the proposals.

Read the letter in full.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Launched during June’s record-breaking heatwave, the rapid snapshot survey asked healthcare workers about their working conditions including the availability of air conditioning and ventilation, and the impact of excessive heat on staff wellbeing and patient care.

It also sought views on whether there should be a legal maximum working temperature in healthcare settings.

The initial findings, which are on our website, have been reported in several publications.

Maximum workplace temperature

They include the Daily Telegraph, which highlighted DAUK’s calls for a legal maximum workplace temperature.

The Morning Star focused on responses of NHS staff, who spoke about colleagues collapsing as workplaces reached 43C.

Meanwhile, Pulse, GP Online, and Management in Practice drew attention to the challenges faced by GP practices.

The survey has now been completed by more than 1,000 doctors and NHS staff.

Calls to improve conditions

The final results are being collated and will be sent to the health secretary with our calls for improving conditions for healthcare staff in the future. They will also be shared with media outlets.

We’re calling for:

• Legal maximum safe working temperatures for hospitals and GP surgeries
• Urgent investment in air conditioning and cooling mechanisms in hospitals
• Urgent investment in insulation and energy efficiency upgrades in hospital infrastructure so that temperatures remain constant all year round
• Standardised and transparent process for healthcare professionals to report high working temperatures
• Local plans for enhancing safe resting and cooling periods during hot temperature working, including cold water drinking facilities
• Urgent investment in urban and rural green space enhancement due to the impacts on local cooling and decarbonisation
• An accelerated focus on decarbonisation, with the climate crisis being treated as the number one threat to the health of the UK public, including an urgent public health education campaign on the impacts of climate change on health

Dr Matt Lee, DAUK sustainability lead, said: “Thank you to everyone who took the time completed the survey and share their experiences.

“Together we have highlighted the reality of working in the NHS during heatwaves with a national audience.

“The next step is for us share the results and the experiences of NHS staff with the health secretary and the Department of Health, and to press for safer conditions for workers and patients.”

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

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Dr Steve Taylor was speaking on LBC after the BMA announced the government had ‘made a new offer’ at the last minute which it would put to its members for a vote.

Dr Taylor said: “It’s about who’s in charge and how they are listening.

“It seems to me that when Wes Streeting was in charge, he wasn’t listening anymore and it became a challenge for the BMA to have conversations.

“They’ve now had a conversation with somebody new and managed to get something done.”

Change in health secretary

He added: “It’s possible that the change in health secretary has made a difference. We know that happens a lot.”

Dr Taylor described the agreement as ‘a compromise’ and said he hopes it’s acceptable to both sides.

He said: “It was always a negotiation. It was always a compromise, but from what I’ve read, it seems to fit both sides okay.

“I think it’s going to be good for us as taxpayers and good for resident doctors.”

Rewarded

He added: “We don’t want any strikes. We want people to be working hard in the NHS and being rewarded well for what they do.”

Listen to Dr Taylor’s interview on LBC in full on the DAUK Instagram.

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Speaking to Pulse Today, Dr Steve Taylor, GP co-lead for the Doctors’ Association UK (DAUK), questioned what the plans aimed to achieve.

Dr Taylor said: “What are we trying to invent here? Is it outpatients in the community or is it actually community care?

“I think there is a sort of mixed up approach that we’ve got going on here, and I’m slightly concerned that we are missing something in terms of what we already have, and how do we integrate that better.”

Dr Taylor pointed out that general practice already provides local neighbourhood care across the country.

He said: “There are already 6,300 neighbourhood centres in the community within walking distance of 85 per cent of the population.

“In a city like Manchester people can access hospitals relatively easily. Rural communities need local access.”

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

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The Department of Health and Social Care has announced community-based optometrists  will be able to refer patients directly and digitally into NHS hospital eye services with access to relevant patient records to support faster and more accurate clinical decisions.

The move is intended to improve patient access to specialist eye care, reduce waiting times, and free up GP appointments by removing the need for patients to obtain a referral through their family doctor.

Dr Steve Taylor, DAUK GP co-lead, welcomed the change.

No-brainer

Speaking to Pulse Today, he said: “Of all the things that GPs don’t need to be dealing with, eyes is one of them.

“It makes sense that opticians can refer directly regarding eyes. It’s probably a no-brainer.  

“It probably just takes a bit of the delay out of the service. If an optician refers to a GP and asks us to refer to the eye hospital, we’re not going to say no.”

Read the Pulse article and Dr Taylor’s comments in full.

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Pharmacy Magazine reported that Asda was offering its reward card customers a £2 ‘bonus’ if they present at one of its pharmacies after being bitten by an insect.

Dr Steve Taylor, DAUK’s GP co-lead, said the scheme appeared to act as an ‘inducement to patients to get them to access Asda pharmacies and use the Pharmacy First infected insect bite pathway’.

An ASDA spokesperson said: “Customers are already being bitten and are shopping within our stores.” They added the funding came ‘solely from ASDA’.

Read the Pharmacy Magazine report in full.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.