Behind the scenes at a North Shields GP practice facing ever-rising demand

Most of us have visited the GP at some point in our lives.

The local surgery is, after all, the first port of call for the vast majority of people when illness strikes.

As pressures on the NHS ramp up for winter, I spent the day at Spring Terrace Health Centre in North Shields, to see how staff deal with the demand.

The first thing to note is that alongside GPs themselves, a team of other medical staff is involved in treating patients - each with their own specialism.

Among them is paramedic Danielle Nimmo, who was taken on by the practice earlier this year to ease the strain on the doctors' time.

She generally treats those needing on-the-day, urgent appointments for issues ranging from chest and throat infections to skin problems.

Ms Nimmo told me: "The GP isn't always available for a same day appointment and that's where I'm here.

"I can see a patient, I can provide that care that they need at the time that they need it."

Ms Nimmo told me she could understand why people might prefer to see a GP but explained: "I do have a lot of skills and I have been there to save somebody's life."

More than 5,500 patients are registered at Spring Terrace Health Centre, which is based in the heart of North Shields.

The practice has a higher than average number of patients who are over 65 years old.

More than 60% have at least one long term health condition, such as chronic obstructive pulmonary disease (COPD) or kidney disease.

For practice nurse Lisa Mordue, helping people to manage these long standing conditions is a priority.

The aim, she told me, is to help people live well and reduce the need for urgent treatment, which would, in turn, put extra pressure on health services.

Ms Mordue explained: "In our area lots of our patients have long term health conditions and it's really important that we see them regularly to support and help them to manage their conditions, not only because that will help in day to day life but also it will help to reduce the risk of them having to come back into the surgery."

From first thing in the morning, there is rarely a moment when the phones at Spring Terrace are not ringing.

Practice staff take between 250 - 350 calls every day, with Mondays usually being the busiest day of the week.

There are also calls to be made out to patients, for example, inviting them for blood tests.

Spring Terrace Health Centre - in figures

• 5,635 patients

• 24.4% over 65 years old

• 61.1% at least one long term condition

• 1,100 appointments held each week

• 65% of appointments face-to-face

Source: Spring Terrace Health Centre

Since the pandemic, GP practices generally have come in for criticism from those who argue it has become more difficult to see a doctor face-to-face.

At Spring Terrace, lead GP Dr Philippa Male told me that can be hard to take.

She said: "You know you're coming in one or two hours before you start to get admin done - to go through letters from the hospital, to go through blood results that have been done on your patients earlier on in the week."

According to this practice, around two thirds of appointments are "in person", with the rest carried out virtually.

Dr Male said while face-to-face consultations are more satisfying for staff and patients, demands on the system mean they are not always possible.

"We're here all the time, for everybody and we just want to make sure that we're delivering really quality, safe care for those patients and I believe we are, but things have changed and we need to operate in a different way."

Since the pandemic, staff at Spring Terrace say they are treating a greater number of patients, with many more unwell than before.

Now, with winter approaching, Dr Male told me she is witnessing a new issue: patients - who are not on benefits - struggling to pay the cost of prescriptions.

She said: "It might be a lady who thinks - 'Can I afford my HRT prescription?' or it might be a young person that's working two jobs that thinks - 'Have I got enough money for my anti-depressant medication?'"

As the day draws to a close at Spring Terrace, the team is already looking ahead. The phone lines will re-open at 8am, with a new group of patients to care for.