The Daily Telegraph

Time to listen to GPS’ complaints of stress

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sir – As a recently retired hospital consultant whose wife is a GP, I take issue with J Meirion Thomas’s claim (Comment, December 19) that the stresses experience­d by GPS are the same as those faced by consultant­s.

GPS work in relative isolation and without the support staff available to hospital consultant­s, who also have immediate access to diagnostic and other services that are not so readily available in general practice. In addition, the nature of clinical problems which may be a source of stress to a hospital consultant are quite different from those faced by a GP.

I agree that urgent considerat­ion should be given to restructur­ing primary care in the NHS, but question how realistic it is to train nurses to be clinical specialist­s in general practice when there are barely enough to support existing services. With regard to these nurse specialist­s providing support for GPS in caring for patients with chronic conditions, Mr Thomas may be interested to learn that practice nurses already do this.

If radical reforms in primary care are to take place, they should be led by GPS who understand the sources of stress that are harming recruitmen­t. Richard Nutton

Edinburgh

sir – I am a GP, and have contact with many trainees, some of whom are disillusio­ned by their administra­tion workload. Every day, before a patient is even seen, there are hundreds of blood results to look at, with each abnormal one requiring further assessment, as well as medication reviews and hospital letters to act on.

It is time to separate primary care into urgent care, seeing patients on the same day for acute ailments, and chronic disease management and elderly care. This would enable more considered consultati­ons for complex patients, and efficient and safe consultati­ons for acute conditions. It would also reduce the burden on A&E department­s.

Overlying all this is the crisis in social care. I hope the Government starts cross-party talks with the urgency that this problem requires. Dr Marion Latimer

St Helens, Lancashire

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