Written evidence submitted by Dr Simon Hughes (FGP0011)

 

General Practice needs more GPs and Practice Nurses. There are significantly less now than there were in 2015 when it was recognised there were 5000 more GPs needed.

Other staff such as Pharmacists and Paramedics are very helpful in many Practices including our own but they cannot do the work of the doctor.

Complexity and multimorbidity has made the role of the GP much more challenging and time consuming.

GPs need a minimum of 15 min appointment times. (Incidentally this means in my view that the MRCGP exam should be changed as the RCA is not currently examining what is important).

PCNs are still in their infancy. Most have not yet had any significant impact on patient care and public health.  Covid slowed the process down and it will be years before they are embedded in the local systems and they need to be given time to evolve. We have a good relationship with the other Practices in our PCN but all struggle due to high patient demand and not enough GPs.

GPs are fatigued and worn out. We have multiple trainees in our Practice and I am concerned that they are being put off entering full time GP due to the hours they see partners working. More of us are retiring earlier than we had originally planned because of the workload pressures which are adversely affecting doctors’ physical and mental health.

 

Money is not the issue here. The Winter Access Fund will make little difference. We need more GPs and more space – premises are not big enough in most areas incl our own.

Doctors would love to provide the care that they believe patients need but are currently prevented from doing so by lack of resources.

 

The pandemic has had a huge impact on workload, and GP and staff morale which is ongoing. Staff morale has been especially affected by aggressive and rude behaviour of increasing numbers of patients. This behaviour has been exacerbated by articles in some of the leading national newspapers.

 

I would echo the RCGP Chair, Martin Marshall’s call for reduced bureaucracy, regulation (incl CQC scrutiny), QOF targets and other targets in the PCN DES until at least a time when GP numbers are high enough for manageable workloads. For the next few years, I would advocate a high trust approach which enables GPs “do the right thing” for their patients.

 

GP partners are choosing to work part-time to avoid being caught by the pension annual allowance problem.

 

I still believe the partnership model is the best option for patients and doctors. It may look different from today and perhaps might involve larger partnerships or even companies but while Drs are running the businesses and are invested in them, they will inevitably be highly motivated to want to see them succeed. In a study by Beds and Herts LMC it was clear that the majority of GPs including salaried and locums prefer working for partnerships.

For any patient with chronic and complex problems having a relationship with a GP who knows them well is still hugely important –psychologically and physically and is also safer and more cost effective.

 

Nov 2021