Thousands of GP appointments 'lost' due to children with conjunctivitis being turned away from nursery, says RCGP

Publication date: 13 November 2016

An estimated 160,000 GP appointments could be freed up if schools stopped sending home children with infective conjunctivitis, according to the Royal College of General Practitioners.

The RCGP says that cases of conjunctivitis are unintentionally ‘clogging up’ the GP appointments system because some schools are refusing to admit children with the condition unless they have a prescription for antibiotics - leaving many other patients struggling to see their family doctor or practice nurse.

To mark the beginning of national Self Care Week, the College is writing to schools inspectorate OFSTED calling for nursery, pre-schools and childcare providers to re-think their policy.

The RCGP has also produced a leaflet of ‘top tips’ to help teachers, childcare professionals and parents make the right decisions about the care of young children with the eye infection.

Infective conjunctivitis – sometimes known as ‘pink eye’  - is a common condition usually caused by viruses, an allergic reaction or irritating substances coming into contact with the eyes. It is usually painless and in the majority of cases, the condition will clear up on its own within two weeks, or can be treated with over the counter lubricant eye drops or anti-allergy medication.

Most cases will not require antibiotics and there is little evidence to show that they help the condition any more than waiting for it clear up naturally.

The College says that if all nursery schools followed the correct clinical guidance, it would enable GPs to focus their time on patients most in need;  reduce the pressure on GPs to prescribe antibiotics, and support the ongoing global effort to tackle antimicrobial resistance.

Research published in the British Journal of General Practice* earlier this year revealed that the vast majority (86.7%) of nursery schools across England, Scotland and Wales currently exclude children with conjunctivitis from attending, while half of these (49.4) refused to admit them without a prescription for antibiotics.

This goes against clinical guidance from Public Health England advising that treatment for conjunctivitis is only appropriate, and indeed necessary, in severe cases.

It comes at a time when hard pressed GPs are carrying out more consultations than ever - currently 370m a year and 60m more per year than even five years ago - yet patients in some areas of the country are facing waits of up to a month to see their family doctor or practice nurse.

The RCGP also highlights the knock-on benefits to the wider economy of parents not having to take unplanned time off work.

Professor Maureen Baker, Chair of the Royal College of GPs, said: “We’re sure that nurseries and schools mean well by sending children home, or requiring them to take antibiotics, as a way of trying to contain cases of conjunctivitis.

“But they need to be aware of the huge impact this is having on GP workload and the amount of appointments we can offer, as well as on working families and wider society.

“GP practices are being swamped with requests for appointments and antibiotics to treat minor conditions, including conjunctivitis, and these cases are clogging up the system, which leads to longer waiting times for patients whose needs might be more urgent.

“Infective conjunctivitis is an unpleasant condition but antibiotics are not the answer in most cases – especially as it’s a viral infection where antibiotics are ineffective.

“While antibiotics are excellent and life-saving drugs when prescribed for appropriate conditions, growing resistance to them will have severe consequences for the health of our population globally.

“It would be incredibly helpful if nursery schools would change their current policy on children with conjunctivitis to ease the pressure on GPs and reduce unnecessary consultations at a time when patients are finding it more and more difficult to get an appointment with their GP.

“We hope that OFSTED can put steps in place to ensure that the correct clinical guidance is followed, in the interests of all our patients, so that GP time and expertise is directed where it is most needed.”

 


Further Information

*http://bjgp.org/content/early/2016/07/05/bjgp16X686125

Download the RCGP's new poster on caring for children with infective conjunctivitis here.

Read more about the College's work on eye health here.

RCGP Press office: 020 3188 7574/7575/7633
Out of hours: 0203 188 7659
press@rcgp.org.uk

Notes to editor

The Royal College of General Practitioners is a network of more than 50,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.

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