General practice: picking up the pieces

by Peter Blackburn

As GPs and services reach breaking point, doctors leaders decide to launch a campaign to rebuild general practice

Location: England Scotland Wales
Last reviewed: 28 March 2022
rebuilding general practice panel

‘First of all, can I say it’s a bit of a surprise for me to find myself on the same panel as the BMA. 

‘I can remember six years ago cycling down Whitehall and there was a demonstration outside number 10 [Downing Street]. As I got closer, I found my name was on some of the placards. I did a rapid u-turn and thankfully no one recognised me in my cycle helmet.’

Six years ago, at the height of the dispute over the junior doctors’ contract, it would have been incredibly hard to imagine former health secretary Jeremy Hunt and doctors leaders from the BMA sharing a stage. Fast forward those six years and, at the launch of a campaign to rebuild general practice, that is exactly what happened. 

Jeremy Hunt HUNT: Shared opinions

As Mr Hunt, now chair of the Commons’ health and social care committee, said speaking at the event at the King’s Fund in central London, that this was the case is a recognition of the stark seriousness of the times.

He said: ‘I’m as surprised as I’m sure the BMA are that I’m here, but the reason is that I fundamentally agree…that there is a crisis. I always believed that general practice is the beating heart of the NHS, it is what makes it special for many patients as well as being an incredibly important part of the prevention agenda and all the things we need to change in healthcare.’

Short on staff

A new poll of nearly 1,400 GPs highlights exactly the crisis Mr Hunt mentions, with doctors’ concerns focusing heavily on staff shortages and a lack of time in appointments as the main factors affecting patient safety.

The poll reveals that 86 per cent of GPs feel they do not have enough time in consultations with patients and 77 per cent of GPs feel GP shortages put patient safety at risk. 

The poll reveals that 80 per cent of Welsh GPs and 86 per cent of Scottish GPs have felt anxiety, stress, or depression in the last year. And 79 per cent of Welsh GPs and 65 per cent of Scottish GPs do not think they have enough time with patients to allow for a comprehensive diagnosis for patient safety.

We are stretched to breaking point’
Dr Sharrock

The BMA and the GPDF are funding the campaign which urges the Government to deliver on its commitment to deliver an additional 6,000 GPs in England by 2024.

The campaign also demands ministers and health leaders tackle the factors driving GPs out of the profession such as burn out and create a plan to reduce GP workload and improve patient safety.

Rachel Ward WARD: Firefighting daily

Speaking at the launch of the campaign, BMA GPs committee deputy chair Kieran Sharrock said: ‘Even before the pandemic, general practice was on the edge. Now, we are facing the biggest public health crisis in a century. 

‘COVID has been relentless. Every day, colleagues around the country tell me about the challenges they face. Each has a unique story, but they are all united in one message: We are stretched to breaking point.’

Dr Sharrock added: ‘To say healthcare staff are overworked is a titanic understatement. One survey, from last July found that 51 per cent of GPs are suffering from burnout, depression, or other mental strain. And over the last year, the equivalent of 279 fully qualified, full-time GPs have left the workforce altogether.

‘When I ask colleagues why they are reducing their hours, they tell me: “I cannot cope. I am burning out”.

‘Doctors worked around the clock to vaccinate and now, a backlog of non-COVID cases is starting to catch up with us, breaking like a tsunami over general practice.’

Recent data shows that on average GPs are conducting 37 appointments every day – almost 50 per cent more than the recommended number of 25. Last November, GPs in England conducted more than 19 million appointments face to face.

Dr Sharrock said: ‘Despite this heroic effort, demand is at record levels and there simply aren’t enough GPs. The result is our current crisis: hospital waiting lists are longer than ever. People are living with undiagnosed illnesses. And families know the frustration of sitting on the phone, on hold calling up every day to try to book a doctor’s appointment.’

Benefit of NHS

The campaign aims to give GPs across the UK the time back to deliver the quality of care they want to be able to give patients while ensuring they are cared for by the right team member.

It also aims to resolve the difficulties many patients face in getting timely GP appointments and to benefit the NHS as a whole by alleviating pressure on hospitals. It is hoped the campaign can also help to tackle the backlog which existed before, but has been exacerbated by, the pandemic.

Appealing directly to the Government, Dr Sharrock said: ‘Ignoring the wellbeing of our people is at the NHS’s peril… All that we are asking is that the Government trust GPs to lead.’

GPs are rushing headlong for the exit’
Dr Sharrock

On the panel launching the campaign were Oxfordshire GP Rachel Ward and York GP Brian McGregor.

Dr Ward said: ‘I feel I can’t give them [patients] the care they deserve and the care I know they need and that’s because every day we are basically firefighting.’ 

 Brian macgregor McGREGOR: Decision fatigue

And Dr McGregor added: ‘When you see 46 patients a day you get decision fatigue and then there is a risk to patient safety.’

The BMA has repeatedly warned that the workforce crisis in the NHS and general practice is ‘not sustainable’ with vacancies soaring and GP numbers declining. 

Dr Sharrock said: ‘GPs are rushing headlong for the exit, and the UK Government is planning another review in England. This is fiddling while Rome burns. 

‘I implore our political leaders as the cost-of-living crisis bites: if you raise taxes to pay for NHS improvements yet fail to stem the flow of GPs out of local surgeries, standards will drop, waiting times will rise, and you will face a wall of public anger. We must rebuild general practice, together, now.’

Photos: Rebuild General Practice