GPs cannot function on goodwill alone

At the end of this year, unless NHS England can find another provider, Field House Surgery in Bridlington will be forced to close its doors as chronic GP shortages meant that the current providers have returned the contract.

In Bridlington, the closure of a GP surgery this size will spell disaster for thousands of patients. Unfortunately, the damage doesn’t stop there. As neighbouring surgeries deal with the inevitable fall out of displaced patients, they will be placed under increasing strain and may struggle to cope.

Sadly, this is not an isolated case. Throughout Yorkshire and the rest of England, general practice is facing a crisis, with NHS England identifying 800 practices that are ‘vulnerable’.

In such circumstances, you would hope the Government would step in, come up with a rescue package to help residents receive the standard care they need and deserve. Unfortunately however, the opposite is true.

The Government’s new mantra ‘transformation’ is a nice rhetoric in theory, however, practices do not reach breaking point by themselves. Without the necessary funding and staff to oversee this transformation, the reality is that these services will wither and fail.

These 800 practices were not always ‘vulnerable’. Rising patient demand, cuts to funding, staff shortages and more unfunded work being moved from hospitals into the community are circumstances beyond a GP’s control.

A British Medical Association survey highlights how dire the situation has become with a third of GPs considering retiring earlier than normal and one in ten admitting they are hoping to leave the country to find work elsewhere.

Having lost two of my colleagues just over two years ago to Canada, it is becoming increasingly difficult to continue to watch my skilled and experience colleagues reach a point where they no longer feel valued in their profession as the increasing demands placed upon them become unbearable.

In communities across Yorkshire, an ageing population is placing significant pressure on the healthcare system as problems become more chronic in nature and appointment times must be extended to reflect this.

The impact of decreasing levels of social support often leads to people seeking help from their GP for issues that aren’t necessarily medical.Often I have given someone assistance with an employment or housing issue. Having the ability to see a GP within easy reach is vital for patients, particularly families, old people and the vulnerable. As I myself have witnessed, the GP surgery is often the lynchpin of the NHS in an area and removing this leaves a significant hole.

Remote areas and practices in rural areas in Yorkshire are under particular threat. Travelling to visit a patient can often take up to an hour and a half as opposed to twenty minutes in a city. We must do more to protect these vulnerable rural practices who face uncertainty as the odds are stacked against them.

Towns and small communities now have GP surgeries who cannot take any more patients. In Cottingham, the situation has reached crisis point, as a rising population and the struggle to recruit more GPs has led to all practices closing their lists. Throughout the rest of Humberside, 10 per cent of practices have had to close their lists. The Northfield surgery in the former mining community of Thorne has two doctors serving 10,000 patients on its books.

Despite the best efforts of hardworking staff, or how far resources can be stretched, this kind of workload is both unsafe and unsustainable. One in 10 GP trainee places were left unfilled this year. The Government needs to urgently remedy these endemic shortages as too many GPs are leaving the profession and too few medical graduates are joining.

With hundreds of GP practices facing financial uncertainty or possible closure, we need the Government to step up and deliver a comprehensive rescue package that safeguards GP services for patients. We cannot and should not accept a situation where thousands of patients are left without a local GP practice that can deliver the care they deserve.

We want general practice to function so that we can treat our patients in the best way possible; that is why we became doctors. But the “transformation” which NHS England calls for cannot be done on goodwill alone.

Dr Krishna Kasaraneni is a GP in Yorkshire and medical director of Humberside Group of Local Medical Committees.