More GPs please

by David Bailey

Train and employ more doctors to escape the cycle of frustration aired by patients

Location: Wales
Last reviewed: 20 June 2022
david bailey

There are some common perceptions around general practice; some true and others born from the pressures COVID exacerbated.

After people took to their doorsteps to clap for doctors and healthcare staff, showing their appreciation for their dedication during one of the hardest times in our careers, the viewpoint changed, and GPs found themselves bearing the brunt of anger. ‘GPs aren’t working,’ seemed to be a common view, along with them closing their doors.  

It is clear patients are having difficulty getting medical assessments and may be told to ring the surgery at 8am, where they join a queue of others trying for an appointment. Patients are frustrated with the process and the wait.

Inside the surgery, GP appointments are filled; a mix of patients who come into the surgery and a slew of telephone appointments and call backs that need to be made. Staff struggle to balance phone calls coming in for appointments, and receptionists triage – often asking the reasons for the appointment and delving a little deeper.

This is for good reason; to understand whether an appointment with a GP is necessary, or whether another option may be more appropriate in primary care – be that seeing a GP nurse, a pharmacist, optometrist or dentist.

We’ve never stopped working hard for our patients and it’s frustrating to hear people saying otherwise. I’ve been a GP for 36 years and the past couple have been some of the most difficult in my career. Things have eased slightly but we’re still extremely busy, from the moment we step into surgery in the morning, to when we close in the evening.

Advance appointments are only part of the solution. The issue is capacity. When practices are fully staffed, then providing different ways to get appointments helps staff and patients.

The problem arises when the capacity of the practice – because of staff shortages – can’t keep pace with demand. Other health professionals can certainly help, if they’re available to, but ultimately, many patients do need to see a GP and there simply aren’t enough.

If you don’t address capacity, you don’t address demand. The only answer to changing the state of primary care is to train and employ more GPs in Wales and create an environment they will want to keep working in.

All community pharmacies in Wales are now able to offer an extended range of services, as part of new reforms, which mean patients have more accessible NHS services closer to home.

This will, to some extent, free up general practice for patients with more complex needs and we’re welcoming of this initiative, and anything that will take the strain off, but ultimately, more GPs is the only answer.

Waiting lists in secondary care present problems for us, as we’re continually asked where people are in the queue. We don’t have sight of this, and therefore not only can we not answer, but patients are often told while they’re waiting, that if it gets worse, to contact their GP. Inevitably they’ll get worse while they wait, which means another GP appointment.

A system that allows visibility of hospital waiting lists would mean understanding for patients, who won’t have to chase their GPs continually.

E-prescribing has many benefits; allowing patients to access their prescription at a pharmacy of their choice, reducing the need to attend their GP surgery for prescriptions following remote consultations and for those with repeat prescriptions. This increases our opportunities as GPs to carry out consultations with other patients in need.

It’s also important people are aware of which services to access. Pharmacists help with common minor health complaints; minor injuries units offer health advice; out of hours can usually be accessed by dialling your GP number in an emergency and NHS 111 Wales is open 24 hours a day.

This isn’t palming patients off but making sure patients can see a health professional and the right one for their needs, which isn’t always a GP.

My GP colleagues are passionate about their work, but this passion is waning under the weight of demand so intense, many are considering leaving the profession. A profession that was once the backbone of the community. We need action from Welsh Government to ensure we can once again be there for our patients in the way they so desperately need us to be.

David Bailey is a GP in Caerphilly and chair of the BMA’s Welsh council