A Bristol GP has warned of "trouble on the horizon" unless action is taken to address staff shortages and morale in the profession. Dr Rachel Warrington spoke of the "relentless" pressure and workloads faced by GPs, in response to a new government report highlighting issues in the system.
The Bristol doctor was speaking on BBC Radio 4's Today programme this morning (Thursday, October 20). She said of the new report: "I've had a brief look - there are some good recommendations in there and I did note that one of the main themes was continuity. I think that's the main aim for most GPs to be fair.
"We all try to practice continuity because it's good for the patient and it's also good for the doctor. The main problem and the thing that the government continue to miss each time is that for good continuity you need capacity - and we just don't have the capacity."
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Patients at GP surgeries across the UK - including here in Bristol - have said that seeing the same doctor each time they visit would be more beneficial. However many GPs in the region say that surgeries simply don't have the capacity to make that happen.
It comes following a new report from the Health and Social Care Committee, which has accused the government and NHS England of being "reluctant" to acknowledge issues in the system, warning that problems are not being solved with "sufficient urgency". The government's pledge for all patients to see a GP within two weeks would "not address the fundamental capacity problem causing poor GP access", the group of MPs added.
Chancellor Jeremy Hunt was chairman of the group until October 14 and the new report, which will have been partly written while he was still in charge of the committee, calls out a number of significant issues facing the sector, including "unacceptably poor" patient access and GPs being "demoralised". The committee had previously spoken about the "uberisation" of the family doctor service and now warns that booking an appointment with your GP should not be "like phoning a call centre or booking an Uber driver who you will never see again".
In their report, MPs raised concerns about "continuity of care" and said the majority of GPs no longer have individual patient lists, meaning the ability to see the same GP has now "worsened". Also speaking to Today earlier was an 84-year-old man from Bristol, whose surgery in the city aims to ensure patients see the same GP each time.
He said: "It's easy for me because I can feel relaxed when I come here and I know that the doctor I'm seeing, or my local doctor that I'm seeing on a regular basis, knows me enough and that gives me the assurance that our doctors can be straight with us, they can be like a friend."
The new report also highlighted "unsustainable" workloads for GPs and went on to say: "General practice is the beating heart of the NHS and when it fails the NHS fails. We know up to 90 per cent of healthcare is delivered by primary care, yet currently the profession is demoralised, GPs are leaving almost as fast as they can be recruited and patients are increasingly dissatisfied with the level of access they receive."
According to a spokesperson from the Department of Health and Social Care, who said the priorities there were "ambulances, backlogs, care and increasing the number of doctors (ABCD)", "there are nearly 1,500 more full-time equivalent doctors working in general practice now than in 2019" and the department said it is spending "at least £1.5billion to create 50million more appointments by 2024, alongside making changes to reduce the workload of GPs and free up appointments". However, Dr Warrington said there was a problem they hadn't yet addressed.
'Trouble on the horizon'
She said: "They talk about trying to recruit 1,000 GPs, funding 1,000 more. The problem is, in the next five years 19,000 GPs are set to leave. So, things are pretty poor at the moment but there's a lot of trouble on the horizon and things are going to get a lot worse and they need to address that.
"The problem they have at the moment is retention and I don't think they've quite realised that. GPs are working harder than ever, long hours - it's unsustainable hours, it's relentless - and if that number of GPs do leave, if the survey is correct then the service will be in crisis."
Asked what needs to be done right now to make the life of a GP easier, Dr Warrington said: "I think overnight they could increase morale and retention so easily by just recognising the non-clinical work we do and incorporating it into the working day. It's so simple, that's all they have to do.
"So, an average GP will work every month probably about a week on top of their normal working hours. It's unseen and it's unpaid.
"If they incorporated that into our working day, the GPs lives would be improved tremendously. But it's the elephant in the room, because when they do do that, probably capacity would go down slightly because we're doing the administration work in our working hours.
"Hospital doctors are allowed to do that, GPs are not." And in response to Labour's mention of the need to double the number of medical school places, with the Bristol doctor being asked if she thought it would make a difference if it could be delivered, Dr Warrington said: "I think it would make a huge difference. I'm not sure whether it could be done though - I don't know whether medical schools have the capacity because so many have been merged and shut in the last 10 to 20 years."
A spokesperson for NHS England said: “We have expanded the primary care workforce by 19,000 since 2019, with more new roles such as GP assistants and digital leads introduced from this month to help patients get the right kind of help from the right professional when they need it, and give family doctors more time to spend with those patients who need them most.
Thanks to this additional investment, GPs and their teams have provided 10 per cent more patient appointments this year compared to pre-pandemic, and we continue to implement plans to further improve patient access, experience and care.”
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