Important role of our primary health care teams

YOU probably know the GP you would like to see if given a choice – but do you know your “primary care team”?

The primary care team embodies all those who see patients in the community and these include nurses, healthcare technicians, pharmacists, opticians, dentists, and many others.

Increasingly this front-line team is expanding to include physiotherapists, occupational therapists and other specialities that in the past were only referred to by a GP or other professional. So what has changed and why? When I started in my rural practice 22 years ago, we had one practice nurse. The GPs did most things themselves.

If a patient needed a blood test I took it. I filled out forms myself and checked routine blood pressures regularly. I saw a much smaller number of patients a day.

Now my practice employs a large number of clinicians with more nurses, healthcare technicians, phlebotomists and pharmacists than doctors.

We look after more frail and elderly patients with multiple complex medical problems and we have taken over much of the work that used to be carried out in hospital outpatient clinics by consultant teams.

What hasn’t moved with the workload is proportional funding, and increasingly the proportion of the total NHS spend in Wales has reduced in primary care.

Workload and complexity has therefore increased unrecognisably.

General Practice is struggling to recruit and retain GPs and the reality is that there will be less GPs per head of population and those GPs will need to concentrate on seeing the most complex medical problems.

Practices such as ours have changed the way we work and how patients access the service. Patients wanting an appointment at the surgery discuss their needs with a trained nurse who ensures they see the right professional at the right time.

This means patients can often access care without a long wait and the GP can spend more time with the patients they really need to see. For myself I can do less routine clinics and spend more time looking after community hospital patients and “virtual ward” patients who are at home but get visited by a team who concentrate on keeping them out of hospital.

It means that GPs within our team have been able to increase appointment times from 10 to 15 minutes.

It means I see those who need me rather than those who want me and the practice has stayed open and remained sustainable which is not true of all GP practices in Wales.

We need to stop thinking about going to see the GP, and start thinking about going to see the primary care team.

■ Peter Horvath-Howard is deputy chairman of BMA’s Welsh General Practitioners Committee