RCGP highlights GP pressures and the impact they are having on patient care

The following comment piece by RCGP chair Professor Martin Marshall has been published in the Daily Express and featured on the front page of the newspaper

Prof. Marshall highlights the intense workload facing general practice. The message is similar to that which was last week published in the Daily Telegraph in response to critical letters about general practice.

The Express article also runs comments from GP Nick Brown and Vice Chair Gary Howsam, highlighting that general practice needs support. The editorial comment reads: “Losing yet more burnt out GPs from the profession can only make a dire situation worse. This health emergency needs to be sorted out – and quickly – because GPs are suffering, and patients too.”

Martin Marshall’s full comment piece:

GPs and our brilliant teams of practice nurses, pharmacists, physios and other health professionals delivered more than 30m patient appointments in March. GPs delivered more consultations than any month on record. We’re consistently delivering more care, and more complex care, than we did before the pandemic – and whilst this shows how hard general practice teams are working and their dedication to patient care, the ever-increasing workload is not sustainable and it’s taking its toll.

This is a crisis that’s been mounting for years, well before COVID, and it’s one that is impacting on GPs at all stages of their career – as these case studies show – and their patients.

As patients live longer, they increasingly do so with multiple, long-term conditions. This means they have complex health needs and GPs need to have time with them to ensure they are receiving optimal care, and to be able to build relationships with them, so that next time we see them, we don’t need to start from the beginning. Throughout my 30-year career as a GP, some of my most successful patient outcomes have been through having a greater time to consult with my patients.

Being a GP is a stimulating and professionally satisfying career. The “joy” of general practice comes from being able to treat not just a patient, but their families – their elderly relatives, and their young children through building relationships with them. Every effort must be made preserve this.

But this kind of care, which we know GPs and patients both value, and which evidence shows leads to benefits for the NHS, is difficult to deliver when the profession is overstretched, overworked, and severely under-resourced. A worn out GP is not able to practice safely. Even when GPs work ‘part time’, it often means working what would normally be considered full-time, or longer.

One reason we are where we are is historic poor NHS workforce planning. Despite countless government pledges to bolster the workforce, since 2015, numbers of trained, full-time equivalent GPs have fallen by 1,516. Only last month, the government failed to seize yet another opportunity to ensure the NHS has enough doctors, nurses, midwives and other professionals to sustainably deliver healthcare in the future, by rejecting an amendment to the Health and Care Bill that would force them to plan for this accordingly. It was supported by the Royal College of General Practitioners, more than 100 other health organisations, two former NHS Chief Executives and a former Health Secretary, but that was not enough.

We have more GPs in training than ever before, but when more people are leaving the profession earlier than planned,or cutting their working hours in order to safeguard themselves from burn out and protect their patients, we’re fighting a losing battle.

General practice is the bedrock of the NHS and it needs to be supported. The government must make urgent progress on its 2019 manifesto pledge of 6,000 GPs and 26,000 members of the wider practice team by 2024.