GPs suffering due to lack of staff – report
GPs working out of hours are experiencing low morale due to a severe lack of staff and high patient numbers, a new report has found.
The Assembly’s Public Accounts Committee says it is “extremely concerned” about how unattractive primary care out-of-hours services are to medics in Wales.
Doctors have cited lone working, unfilled shifts and not feeling part of a valued team as the main reasons for poor morale.
In rural areas the issues are magnified, the report states, with GPs covering vast geographical areas and faced with difficult logistical decisions in terms of prioritising patients.
“People don’t fall ill or hurt themselves between 9am-5pm, so out-of-hours services are an essential part of the NHS in Wales,” said Nick Ramsay AM, chairman of the Public Accounts Committee.
“We are deeply concerned at the low morale among the staff delivering these services and
sympathise hugely with staff who are often working alone and under pressure due to unfilled posts across the country.”
However, the committee found that innovative schemes being operated by Cardiff and Vale and Hywel Dda University health boards are aiming to tackle this issue.
Cardiff and Vale UHB is supporting out-of-hours GPs with a clinician practitioner, senior nurse lead and an administrative function.
And Hywel Dda UHB is using GPs, pharmacists and senior nurses along with administrators and drivers being trained as healthcare support workers. There are also two advanced paramedic practitioners (APPs) undertaking home visits and contributing within treatment centres.
“There are examples in Wales of health boards taking a different approach to out-of-hours, often with multi-disciplined teams to share the load and broaden the expertise on offer,” added Mr Ramsay.
“We would like to see these examples of best practice shared across the country and urge the Welsh Government to continue its efforts to provide a service which works for staff and patients.”
Dr Charlotte Jones, member of the BMA’s Welsh GP Committee, hopes the report will help to “usher in a new period of investment and policy development”.
She said: “We share the committee’s concerns over the decline in GP numbers across Wales – we’ve been highlighting this for years. The Welsh Government must actively develop policies to increase the number of GPs in Wales and we are pleased that the committee is supportive of our calls.
“BMA Cymru Wales has repeatedly warned of the growing gap between the demand placed upon general practice and its capacity.
“Years of under-investment, along with rising workload, has meant that GPs in Wales are increasingly being asked to do more with less, and out-ofhours care has suffered some of the worst effects.”
“To help combat this, we would urge Welsh Government to support the further development of multidisciplinary teams, but not as a replacement for doctors.”
In response, a Welsh Government spokeswoman said: “Our Train Work Live campaign is helping to attract more GPs to Wales. Work is also being undertaken by clinical leaders to encourage GPs to work in out-of-hours by making it a more attractive place to work.
“The new delivery model for the out-of-hours service is increasingly based around multidisciplinary teamworking, that are less reliant on GPs to deliver the activity but place greater emphasis on their clinical leadership role.
“We will now consider the recommendations in the report.”