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.