GPs in Wales warn of 'grave concerns' for surgeries saying they're on the verge of collapse

  • Report by ITV Wales reporter, Hamish Auskerry

There is a stark warning from GPs in Wales that they are now unable to provide quality and safe care to patients because of their 'excessive workload', with the service being on the verge of collapse.

The head of the British Medical Association Cymru Wales has said his union is issuing a final plea to those in power to listen to its 'grave concerns' and help surgeries pull back from the brink.

Dr Natasha Collins gave up her own practice to go back to being a locum GP because of the pressures she and her colleagues faced, saying her work was "completely unsustainable".

"I was working 12 hours in the surgery, most of the time seeing patients, managing that acute on the day demand and then routine demand where we could" she said.

80% of GPs surveyed say they're under "significant pressure". Credit: PA

"And then racing home, putting the kids to bed but always with work at the back of my mind and then as soon as I could, getting back on the computer doing the administrator stuff that needed to be cleared before I could do it all again the following day."

Dr Collins continued: "To be honest, during those last three months I barely saw my family, I was a really rubbish mum, I missed my five-year-old's first sports day and that's just not sustainable.

"As GPs we try and promote wellbeing in our patients and we just don't practice what we preach really."

"Where I've been able to step back and actually see that what I was doing was not healthy, I now go into practices, so I'm working as a locum GP - providing essential GP services for those practices that are holding vacancies, and I can see those partners struggling and they're living the same life that I was.

"All in the hope that they can provide that patient care that they're looking to provide, that they want to provide but they're just not able to because of the pressures that we're all under."

She added: "It is heartbreaking when you're working those sixteen odd hours a day but you're reading in a newspaper that GPs are not working hard enough etc, it's not that we're not working hard enough, it's that there is just not enough capacity in the system to fulfil the demands of an increasing, ageing population where we are haemorrhage GPs and we're haemorrhage practices essentially."

A survey from the BMA Cymru Wales has shown 80% of GPs are feeling significantly under pressure, with a diminishing work force and rising demands on the NHS adding its toll.

The union is appealing for an urgent rescue package from the Welsh Government to support doctors with their workloads and staff shortages.

BMA Cymru Wales says there is currently a shortage of 664 GPs here, when compared with other OECD countries.

As well as that Wales has had 84 surgery closures in the last decade.

The union says there's now 18% fewer surgeries available to people, with GPs now having to take on 32% more patients each.

The campaign, 'Save Our Surgeries' from BMA Cymru has also shown that there are just 2,324 GPs in Wales with only 1,445 working full-time and over a quarter (26.6%) are planning to leave the profession in the near future.

Dr Gareth Oelmann, Chair of BMA Cymru Wales GP Committee said:

“Today is a defining moment for general practice in Wales, a final plea to those in power to listen to our grave concerns and to step in and save the service from collapse.

19 million appointments were offered last year according to BMA data

“Recent activity data shows that last year (22/23) alone, GP surgeries received a total of 27 million phone calls, with 19 million appointments offered, 1.3 million referrals to secondary care made and a total of 56 million prescription items issued all within a population of 3 million.

“Despite the remarkable efforts of hardworking GPs across Wales, the future of general practice hangs on a precipice because of longstanding underinvestment.

“The strain has been felt up and down the country, we have heard from GPs who have been unable to recruit permanent staff for years on end, examples of extreme burnout and a rising number of surgeries having to close their doors as a result leaving thousands of patients having to be treated elsewhere.'

The BMA union is calling on the Welsh Government to step in with the following rescue package:

  • Invest in the workforce of General Practice to allow the implementation of a national standard for a maximum number of patients that GPs can deal with during a working day to maintain safe and high-quality service delivery.

  • Produce a workforce strategy to ensure that Wales trains, recruits, and retains enough GPs to move toward the OECD average number of GPs per 1000 people. This must feature a renewed focus on retaining existing GPs and tackling the problems driving them out of the profession.

  • Address staff wellbeing by producing a long-term strategy to improve the physical, mental, and emotional well-being of the workforce.

Despite the figures from BMA Cymru Wales, the Welsh Government has said there has been an increase in the number of GPs in Wales over the last two years and in wider practice staff.

Figures for September 2022 show there were 1,974 GP practitioners, compared to 1,963 in September 2020 and 1,926 in 2017.

A Welsh Government spokesperson said: “We greatly value the work GPs – and all healthcare staff in GP practices – do every day.

"We continue to take steps to reduce pressure on GPs, such as the introduction NHS 111 Wales and increasing the range of services community pharmacists can provide. The new Unified GP Contract will help to reduce bureaucracy and free up more time for GPs to see patients.

“We value our ongoing engagement with BMA Cymru Wales in working with us on solutions to long-standing sustainability issues in general practice.”

The Welsh Conservatives have said the Welsh Labour Government has 'a record of serial underinvestment and mismanagement.'

Responding to the warnings by the BMA Cymru Wales, Welsh Conservative Shadow Health Minister, Russell George MS said:

“It comes as no surprise that the BMA are echoing Welsh Conservative calls for greater investment in our Welsh NHS and are warning of our Welsh NHS’ collapse, given that the Labour Government, which controls the health service in Wales has a record of serial under-investment and mismanagement.

“Wales receives £1.20 for every £1 spent on health in England, but only spends £1.05, with Labour being the only government in the UK to have ever cut a health budget, not once, but twice. So it is no wonder that Wales has lost over 20% of our GPs and nearly 20% of our GP practices in the past decade.

“The Welsh Conservatives are urging Labour to enact our call for a comprehensive retention and recruitment plan to restore the health service’s workforce, with a tuition fee refund for healthcare workers that stay in Wales for 5 years after their studies at the heart of it.”

Meanwhile, Plaid Cymru’s spokesperson for health and care, Mabon ap Gwynfor MS said:

“This is a stark warning from the BMA and needs to be a wake-up call for Welsh Government that new thinking is required to address issues across the health service.

“Our NHS is at breaking point and something has to give. There have been long-standing problems with patient flow through hospitals, and with increased pressure on our GPs and emergency services, and more and more patients being added to waiting lists, our hard-working staff have given everything they can.

“This latest warning from the BMA won’t come as a shock to many people around Wales who have been struggling to access their GP surgery, or even seen their local surgery close. When all parts of the NHS are under considerable pressure, the answer isn’t to shift the workload elsewhere – we need radical action to address long standing problems across the whole health and care service.”

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