The situation facing GP practices is ‘unsustainable’ and will ‘continue to spiral out of control’ until Welsh Government takes seriously the concerns raised by GPs and their patients, says BMA Cymru Wales.
A year on from the launch of its Save Our Surgeries campaign, it says the overall state of general practice in Wales has worsened. It is calling on the Welsh Government for an urgent rescue package.
A survey by BMA Cymru Wales has revealed that 91% of GPs are routinely unable to meet patient demand due to unsustainably high workloads affecting appointment availability.
The survey data, which is set to be revealed to members of the Senedd at BMA Cymru Wales’ Save Our Surgeries event, also suggested that 87% of GPs feared their rising workloads were impacting patient safety as Wales saw its 100th GP surgery close this year.
With 100 fewer surgeries for patients to turn to, GPs now see up to 35% more patients each, causing unsustainably high workloads and burnout with doctors forced to work less than full-time to survive.
BMA Cymru Wales said this is resulting in an exodus of experienced GPs, with more than half (53%) of GP partners planning their exit in the next three years and almost a third (31%) of salaried GPs intending to work less than full-time.
With 80% of GP respondents expressing significant concern about the financial viability of their practice, the BMA’s GP committee in Wales says it is in no doubt that the closures are a direct result of sustained underinvestment. Only 6.1% of the NHS Wales budget is invested directly into General Medical Services – services provided by GPs – a reduction from 2005/06, when it was at 8.7%.
The rescue package which BMA Cymru Wales is calling for seeks a fairer portion of the NHS budget, safeguards to protect patient and GP safety with a national maximum standard of patients per day, a workforce strategy to improve the retention and recruitment of GPs and measures to address staff wellbeing.
The calls have been backed by 704 GPs who have signed a letter to the Cabinet Secretary for Health and Social Care asking for immediate action to save general practice from collapse.
The survey also showed that 73% of GPs would be prepared to take some form of industrial action unless immediate steps were taken by the Welsh Government to restore a fairer portion of NHS funding.
Dr Gareth Oelmann, chair of GPC Wales, said:
“GPs from across Wales have shared their experiences with me, and we are all united in our fears about the future of general practice. GPs have told me about the impact on their own health and wellbeing and their huge concerns for their patients. It’s heartbreaking.
“With 95% of GP respondents to the survey telling us they feel negatively about the future of the service and some only giving it a year to survive, inaction is not an option.
“I’m afraid without a fairer portion of NHS funding, the situation is grave, and if general practice fails, the rest of the NHS will follow.
“Our patients are already seeking private healthcare because of the huge waiting lists in secondary care and we’re seeing this trend in primary care. Without immediate action, this inequity will only deepen, impacting on the most vulnerable in our communities.
“We know that if general practice was given a fairer portion of NHS funding for the wide-ranging portfolio of services we provide, the NHS in Wales would have a far greater chance of success, and most importantly, benefit patients overall.
“We’re asking for a rescue package to prevent further practices from closing their doors.”
Dr Rowena Christmas, Chair of RCGP (Royal College of GPs) Wales, added:
“I have been a GP for 25 years. I love my job and feel incredibly privileged to be able to support patients through their most frightening times. It has become almost impossible to provide the caring, quality service that we all aspire to though.
“I am constantly saying sorry to my patients. Sorry that they had to wait weeks for a routine appointment with me, sorry that I kept them waiting past their appointment time, because every consultation now is so complex that no matter how hard I try I cannot run to time.
“Sorry that the ambulance has not come, that they must wait so long for physiotherapy, or to see the counsellor. Hour after hour I apologise for a service that is not as good as it should be. I cannot change this and so it is morally distressing.
“If we had the proportion of the NHS Wales budget we are asking for, we would have a sustainable general practice, with better access for patients, and time to offer holistic, preventative medicine. This would be good for patients and would alleviate pressures on secondary care.”
Gareth Thomas, Welsh Lead for the Institute of General Practice Management (IGPM), said:
“Restoring the proportion of the NHS budget spent in general practice is paramount to secure the long-term financial sustainability for GP practices and enable GPs and their teams to provide the level of access that patients expect and deserve.
“Now is the time for the Welsh Government to prioritise General Medical Services before it’s too late.”
Earlier this month GPC Wales chair Dr Gareth Oelmann wrote to the First Minister requesting immediate action on the delay to the 2024/25 GMS contract negotiations, saying: “We are now actively evaluating all available options in the event of a dispute.”
