Amid an increasing workload driven by older patients with more complex needs the BMA launches its Your GP cares campaign to call for long-term, sustainable investment in general practice
Dean Marshall’s experience within his practice is one that will be all too familiar to GPs up and down the country.
In the past three or four years, his eight-GP surgery has seen a huge increase in patient demand for a multitude of reasons.
There has been an expansion in the local population due to new home developments; an increasing need for longer appointments and home visits for older patients with complex conditions; and more care moving into the community.
‘We are in an area where there’s significant increased house building, our practice has gone up 800 patients in the last two years with no increased funding, so we are now in a situation where we are struggling to cope.
‘Despite providing upwards of 700 appointments with doctors and nurses and healthcare assistants a week, that does not seem to be enough,’ Dr Marshall says.
‘We are doing on average 80 house calls a week and most of those house calls are to people who are elderly. They are not [patients] that we can necessarily manage in another way.’
He adds: ‘We are now in a position where we are struggling to attract doctors to work in the practice and we can’t attract any locums. I had to recently cancel a day’s leave because I couldn’t get a locum to come and cover the practice.’
GPs under attack
His experience in Edinburgh echoes those of many GPs who have been contacting the BMA GPs committee, of which Dr Marshall (pictured) is a negotiator, in recent years.
Hand-in-hand with the rising workload has been plummeting morale, which has also had an impact on GP recruitment and retention levels.
GPs feel under attack, Dr Marshall adds.
This is why the GPC has launched the Your GP cares campaign, which aims to increase awareness of the pressures facing general practice.
Dr Marshall, who was involved with the development of the campaign, says the role of GPs across the UK has undoubtedly come under scrutiny, which at times has felt hostile.
He says: ‘Clearly there’s a major issue with the perception of GPs. Often we are portrayed as the problem whereas what we are trying to deliver some of the solutions that are needed and just cope with the huge increases in demand that we are seeing.’
Dr Marshall says the burgeoning workloads and low morale are deterring doctors and medical students from considering general practice as a career, while more experienced GPs are opting to retire early.
UK applications for GP training fell by 8 per cent this year, compared with 2013.
There were 5,559 applications in the first round of the selection process this year, 472 fewer than in 2013 and the lowest number of UK applications since 2009, according to figures from the GP National Recruitment Office and Health Education England.
‘This year we have got the worst recruitment numbers that I can remember, so we haven’t got people coming in.
‘The ones in training train and then don’t stay very long for a variety of reasons, and because of changes to the pension arrangements we’ve got huge numbers of GPs in their mid-50s [retiring early],’ Dr Marshall says.
‘We’re losing five to 10 years of work from people who previously would have been working so it’s almost the perfect storm.’
This is why Your GP cares is calling for long-term sustainable investment in general practice.
What patients want
The GPC is also examining the future of general practice — what patients want and what GPs can provide.
There are also more patients being looked after at home or in community settings, raising demand further. Demand seems to have outstripped supply.
Dr Marshall gives six-monthly blood test check-ups for prostate cancer patients as an example.
‘Now that may be appropriate [within general practice], as that sometimes benefits the patient who doesn’t have to travel to hospital.’
But he points out there is no accompanying funding or capacity increase.
The increasing complexity of cases also means that GP appointments often over-run the 10-minute consultation time.
Suitable premises to fit the staff in to cope with demand is also a problem. Many are in converted houses.
Fit for the future
Long-term sustainable investment in premises to ensure they are fit for the future is part of the campaign’s demands.
‘They may have been fit for purpose 20 years ago but whether they are now is another issue,’ he explains.
Dr Marshall says the campaign is heavily dependent on grassroots doctors’ activity.
The BMA will be sharing practice materials with individual GPs once they are launched later this month so they can help to get the message out there.
Dr Marshall adds: ‘What we want to show with this campaign is how much we care about the NHS, how much we care about our patients and how we are struggling to actually provide the services that they need and want.’
Join the campaign