Wales General practitioner

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Urgent prescription GP Wales case studies

The issues we aim to address are a harsh reality for GPs working on the front line of primary care. Below, doctors share the everyday challenges they face to deliver the care their patients deserve.

Find out more about Urgent prescription for general practice in Wales

  • General practice is unsustainable

    My 55-year-old partner retired earlier this year leaving me as the sole partner in my practice. I currently employ one full-time salaried GP and two part-time salaried GPs. I’m struggling to find anyone to enter into the partnership. A recent trainee was considering it before he realised you can earn more money for less work as a locum.

    I feel that the intensity of general practice goes unrecognised. During the course of my 11-hour days, I battle with IT systems which are old and unfit for purpose and unbearable levels of bureaucracy. Alongside this, the increase in workload means that I struggle to provide the level of care that I would like to. Clusters were set out as a solution but they aren’t even touching the surface.

    The state of general practice is unsustainable and unless something is done to improve things, patients will suffer, and GPs will walk.

    Dr Steve Short, Cardiff

  • I’m really worried about what lies ahead

    During the last four years I’ve welcomed countless newly-qualified GPs into my surgery, and sadly waved them goodbye as they have discovered the current reality of working in general practice.

    Many doctors are lured into general practice with the promise of an attractive work/life balance. In reality, GPs are struggling to cope with rising workloads and increasing patient demand. These days it’s rare to find a GP who hasn’t considered leaving the profession and I’m really worried about what lies ahead.

    My practice is facing many challenges which are in no way unique. One of our salaried doctors has recently left to do locum work in order to earn more money. One of my partners expressed a desire to become a salaried doctor, due to the pressure of being a partner and coping with the increased workload and bureaucracy that comes from running a business. Because we were unable to accommodate this request, he’s leaving us. We’ve been advertising for a new partner for over six months and have not received one application for the job.

    I’m a father of two young children, and most nights I get home after they have gone to bed. We struggle to find cover for annual leave requests, and I often end up cancelling my leave and coming in to manage the work.

    The current state of general practice is completely unsustainable and something needs to be done to ensure that we can keep providing the care our patients deserve.


  • I end up taking admin work home with me most nights

    I chose a career in general practice as I loved the continuity of looking after patients and their families, but the specialty has changed and GPs on the ground are burning out and feel unsupported.

    At present I work Monday to Wednesday, and am relieved when Thursday appears. I work long hours due to the high level of demand and the increase in administrative tasks that GPs now undertake. I end up taking admin work home with me most nights.

    If I hadn’t chosen to work part time then I’d have no work-life balance. During the last 12 months all of the partners and the admin staff have suffered from stress.

    I’m really worried about the sustainability of the practice I work in, three out of the five partners are over 50 and looking to retire early.


  • Workload pressures have definitely had a negative influence on morale here

    Having managed to survive our own retention and recruitment problems, the practice is now facing increasingly challenging daily workload pressures, with rising demand, partly fuelled by neighbouring manpower issues, one practice in acute difficulties and another closed, with a list to be dispersed. This may have been seen as an opportunity in times when attracting a new partner or salaried doctor was straightforward, but this isn’t the current situation.

    Some days, you know that demand will significantly outstrip the number of available appointments and I am aware that decisions have to be made in this context. It is frustrating and I worry that things will be missed and that I cannot practise the medicine that I want to.

    The workload pressures have definitely had a negative influence on the morale of the practice team. The working day is often longer than the contracted hours and partners frequently perform clinical, as well as administrative tasks, in their own time, outside of work hours. I applaud BMA Cymru Wales’s stance on an enhanced retainer scheme, as this is currently so unattractive that it is rendered redundant.

    I am not considering a move abroad or a career change, but I do worry about the sustainability of my practice. Whilst my work-life balance is reasonable, the intensity of the working day concerns me.

    There is also the prospect of new housing developments, which will mean an increased list size. I frequently hear comments from several disciplines of the pressure that they feel and I’m certain that patients would receive a better quality of care should we be able to have smaller patient lists and more time for our patients.

    At present, I find it difficult to strongly endorse a career in general practice to medical students or juniors, although I try to remain positive.

    Let us all hope that we can see some positive news to ensure the sustainability of the cornerstone of our NHS.


  • The future is bleak and uncertain

    I am a GP Partner in south Wales. I am 36-years-old and had anticipated a further 30 years’ service within the NHS. However, currently the future is bleak and uncertain. I have worked in general practice for 10 years and I have never known morale to be as low as it is now. 

    Within my practice we have three partners. Two partners have retired and although I took the place of one we have been unable to recruit another partner. We also had a salaried GP who left after 12 months as he was able to earn more money as a locum. We have advertised for a GP and despite being a forward-thinking practice in a popular area we have not able to recruit. 

    The current workload is unsustainable and only set to increase. One of my partners is due to retire in April. She has agreed to come back on reduced hours for a year or so but as surrounding practices have also been unable to recruit GPs recently we are not hopeful of finding a replacement doctor, let alone a replacement partner.

    We have done our best to utilise the wider healthcare team and to modernise our practice. We have a minor illness trained nurse, a highly skilled HCA and we triage all urgent requests for appointments to attempt to manage demand. However, with the current and pending cuts in our funding we are not able to expand our current team further.

    I have only ever wanted to be a doctor. I have never thought I would need a 'Plan B' but from the emerging national stories of practice closures I am having to consider this for the first time in my life and I am not hopeful.