The number of GPs working in Wales is falling at a time when demand for appointments is soaring, new figures have revealed. Latest Welsh Government statistics show that Wales had 2,301 fully-qualified GPs active in June compared to 2,324 in March - a decrease of 23.
As many of these doctors work shortened hours, the number of full-time equivalent GPs stood at 1,562 in June which was once again a fall on the 1,581 in March. Similarly there was also a slight drop in the number of GP practices currently operating, down from 389 in March to 386 in June.
Despite this decrease, over the past five years the number of patients registered to a GP practice in Wales has risen by more than 50,000, up from 3.21 million in 2016 to 3.26 million in July 2022. It means pressure on general practice is mounting and leaving its workforce burnt out, according to leading unions.
But the Welsh Government said the number of GP practitioners working in Wales went up by 60 between 2017 and 2022, adding that in the last three years it had exceeded its GP training target of 160 places a year by 90 places.
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Dr Gareth Oelmann, chair of BMA Cymru Wales' general practitioners committee, said the statistics follow an "ongoing pattern of decline" in the number of both practices and GPs which Wales has seen over the past decade.
"In some areas of Wales more than others, we have seen a trend of practices handing their contract back to the health board which can either result in a list dispersal to neighbouring practices or direct management of the practice by the health board. Other practices may have chosen to amalgamate or merge during that time, or to close a branch surgery," he said.
"Whilst managed practices by health boards can have a place in primary care delivery as an absolute last resort, they cannot act as the principal mode of delivery. They are expensive and the level of external management effort required to oversee them is disproportionate.
"Where practices are set to be closed or dispersed, it is imperative that the health board engages with the Local Medical Committee so the impact upon other practices in the area and the wider health economy can be mitigated."
Dr Oelmann said the most concerning element of the figures was the declining numbers of GPs in Wales who were reducing the hours committed to their practice. "This is somewhat unsurprising given the heavy toll of Covid, and the pandemic recovery plus ever increasing demand/capacity gap," he added.
"This is reflected in our consistent calls for Welsh Government to improve the recruitment and retention rates of GPs in Wales where recent GMC data showed we have a higher relative proportion of GPs over the age of 60 than any other nation in the UK.
"To help recruit more GP trainees and ensure more don't leave the profession we need to see the Welsh Government continue to reduce bureaucracy as set out and agreed in the latest GMS contract by lightening the administrative burdens which we have seen. This will free up GPs to do what they are trained to do, namely, to see and treat patients."
Chair of the Royal College of GPs in Wales, Dr Rowena Christmas, said it was "disappointing, yet not a surprise" that Wales has seen a drop in the number of practices and GPs. "Pre-pandemic Wales was served by 404 surgeries, during our most challenging time and now as we respond to a huge workload we have seen a consistent fall in the number of practices with now 18 less than was the case at the start of 2020." she said.
"This is unsustainable. It is forcing patients to travel further to see their doctor and piling on the pressure to my already over-worked colleagues. An RCGP survey earlier this year found that 33% of GPs in Wales did not expect to still be in the profession in five years’ time. And while I applaud the brilliant work of our medical schools in training up the next generation of GPs, we really need further action from Welsh Government to significantly enhance the workforce and the primary care estate.
"The most valuable data regarding total GP numbers is the full-time equivalent figure and this has only been published since December 2021. Even so, we can see a worrying pattern with there being 49 less FTE GPs in Wales in June 2022 than was the case just six months earlier. That is a deeply worrying trajectory."
The Welsh Liberal Democrats claim the GP numbers are "heading in the wrong direction", adding that the key to solving problems in areas like A&E starts with ensuring people have easy access to their community doctor.
Its Welsh leader Jane Dodds MS said: "GPs are our first line of defence when we get ill and are absolutely critical for solving the crisis we have in our accident and emergency departments as well on waiting lists for surgeries. Spotting illnesses early is critical in preventing patients from reaching a crisis point where they need either emergency treatment or more advanced treatment.
"Right now too many people across Wales are unable to access a GP within a reasonable time, many of which then have to go to A&E to be treated. We must ensure the number of GPs in Wales is rising to bring waiting times down. Labour urgently needs to bring forward an action plan to recruit and retain more GPs across Wales."
In response, the Welsh Government said the number of GP practitioners working in Wales went up by 60 between 2017 and 2022. "Overall, there has been an upward trend in the number of GPs practising in Wales in recent years, as well as more trainee GPs and an increase in the number of wider practice staff," a spokesman said.
"We are making a record investment – more than £260m - in education and training programmes for health staff, with plans to deliver an additional 12,000 clinical staff by 2024-25.
"In the last three years we have not only achieved our GP training target of 160 places a year, but exceeded it by 90 places. Our Train Work Live marketing campaign and financial incentives for GP training, including £20,000 for trainees in north Wales and parts of west Wales, has helped us achieve this."
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