Being a GP or running a GP practice is becoming an almost impossible task (Staff at UK GP surgeries facing abuse and ‘tsunami of demand’, 28 Mei). Following a controversial letter from NHS England to general practices recently, the situation feels ever more untenable.
At one and the same time, expectations are being raised of GPs being able to provide unlimited remote advice and to provide traditional face-to-face appointments, if this is the patient’s preference. Behind the scenes, there is the same understaffed workforce and the same number of minutes in each, often 12-hour, dag.
There are no more efficiencies to be made and no more corners to cut. The more we are expected to do “total triage” and online consultations, the less time there is to see patients, with all their human complexity and frailty, in the flesh. Which is it to be?
Perhaps the lack of crowded waiting rooms, necessary in a pandemic, leads to less understanding and empathy of other people’s needs. We are burning out as a profession and this is something we should all be worried about. General practice in the UK is the foundation of the NHS. I urge politicians and GP leaders to manage expectations and encourage kindness from the public.
Dr Charlotte Bryson
GP partner, Sheffield
I am one of those reduced to shouting in total frustration at my GP surgery. Eerste, I do not want to discuss what it’s about with the receptionist. Second, telephone consultations are not the answer. Four of them, and a mobile phone photograph, plus two prescriptions, proved useless, as my condition not only worsened but was exacerbated.
Just as I was about to threaten to camp outside the surgery with the press, a telephone consultation with a third GP grudgingly allowed an in-person appointment with a fourth GP. He diagnosed the problem instantly. How much time, cost, frustration and distress over three weeks could this have saved both me and the NHS if I had been seen in the first instance?
The NHS is failing through a lack of common sense management across the entire system.
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Re your recent article (‘I’ve given all I can’: NHS staff on why they might quit, 22 Mei), as someone who is currently retraining to be a nurse, I can already understand this. I’ve been shocked to learn that on most wards, the minimum patient to nurse ratio is 7:1, edging up to as high as 9:1 when there is a staffing issue.
If nursing involved nothing but looking after patients, this would amount to 8.5 minutes per hour with each patient. With preparations, documentation and other requirements, this easily reduces to five minutes or fewer. Factor in some patients needing more attention than others, and some of them can easily go hours without a meaningful interaction with the nurse. This isn’t nursing; it’s adult daycare with medication rounds.
No one can provide safe, effective care in five minutes per hour. Yes, nursing pay is low and the 1% pay rise offer is derisory, but it’s also about staffing wards adequately so that nurses can do a proper job, not just be overloaded minders who then have to take the blame when something inevitably goes wrong.
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