Written evidence submitted by Dr Tom Lorne McKewan (FGP0055)

I am a GP Partner and have been for almost 15 years. I am also primary care lead for our region, representing 33 practices and 550k patients.

Primary care is swamped with increasing numbers of patients with requests for appointments and access. Staff are burnt out, under appreciated and expected to provide a level of care that is unachievable with the existing workforce and reward.

We have seen more GP leaving the profession than joining and our surgery like many others are one failed recruitment away from collapse.

60-70% of our day is taken up with managing acute care problems and requests for urgent appointments. We must constantly filter each as to what is urgent and needs to be managed on the day which removes a GP from managing to most sick and complex patients.

I want to see the right patients in person at the right time. I want to give them the time they need. I did not come into this job to work in a call centre.

This is unachievable without out a significant increase in available GPs and other clinicians. Unless the job is made attractive both financially and practically it will continue to decline. Stop increasing the demand put on us without providing the workforce first. Simply giving us money to employ staff is not helpful when they do not exist.

Supporting our hospital colleagues has meant more and more complex medical patients are managed in the community by GPs. This has developed with no increase in staffing or funding. Senior GPs are needed to manage this cases but not given the time nor funding to do so while hospital consultant increase in numbers and pay.

We are seeing more and more frail elderly and safeguarding patients due to reduced access to social care and health visitors. These absorb massive amount of time and resource, taking out more and more appointment time.

What makes the job both rewarding and has the best chance of keeping patients healthy for longer is continuity of care. This is only achieved by having a named doctor who has overall responsibility for that patient. There is no incentive for doctors to do this at present other than being a partner. For any new service or proposal, it is partners that are required to absorb the extra work, not salaried or temporary staff.

Current trainees are forced into general practice too early. Being an independent practitioner can be very scary and needs a degree of experience and maturity. Younger trainees prefer the hospital environment with a team and access to diagnostics and tests. They often find leaving hospital a daunting prospect. We should be encouraging them to remain in hospital posts longer to then come into GP when they are ready rather than forced.

Unless becoming a partner is made more attractive for trainees then we will struggle to maintain primary care and keep patients out of hospital in the very near future.

If I were to have my time again, I would not be a GP in this country. In almost every other developed country, GPs are respected more, reimbursed better and have less work pressure. When anything becomes rarer it becomes more expensive. Sort this out before it is too late and we have all left.

I am very happy to be contacted to discuss further if required.                                       Dec 2021