Krishna Kasaraneni: Political failure as GP services wither away

GP surgeries across Yorkshire are at breaking point. They are under unsustainable pressure from a perfect storm of rising patient demand and falling resources that have left many increasingly unable to deliver the services that the public want.

The story I get from GPs is the same wherever they are in our region and beyond: we do not have the resources, the staff 
or in many cases the buildings to meet what we are asking to do. Most worryingly, politicians seem oblivious to this plight, despite the growing evidence that GP services are being overwhelmed.

This is why this week the British Medical Association has launched a major new campaign – Your GP Cares – which calls on the Government to start backing GP services with long term, sustained investment.

Sign up to our daily newsletter

The i newsletter cut through the noise

My own personal experiences demonstrates the need for this campaign. Twelve months ago, I was training to become a GP
 at a rural practice in South Yorkshire with just over 9,000 patients.

I worked alongside five GPs, two of whom were helping to train me and another colleague. It really was a well-run, family practice, providing first-class care for the local community. I jumped at the opportunity to join the practice full time when a spot became available. This was what I always wanted to do and I felt incredibly lucky that the opportunity had come knocking on my door.

Unfortunately, over the past year, things have gone downhill drastically. Admittedly some of the signs were already there in my training. We were always busy and always working at the top of our capacity. Funding from the Government had been frozen for years, leaving our budget under pressure constantly. What we were seeing in this part of South Yorkshire was a real example of the problems that 
the BMA has been warning about for some time.

We now have 10 million older people with complicated conditions that require longer appointments and more intensive care. Around 15 million UK citizens have one or more chronic health issue that requires management in the community while by the dawn of the next decade a million patients will be living with dementia. Three million are expected to living with or beyond cancer by 2030. In short, GP services have in the past few years seen complexity increase along with sheer numbers of patients, but nothing has been done by government to help local practices cope.

In the past 12 months, this pressure has grown and grown, rippling through my practice in different ways. Two senior GPs are planning to leave for Canada partially because of the mounting workload.

It is a sad reality that many GPs are choosing to work abroad owing to the rapidly worsening climate in UK general practice: two of my friends who left three years ago “for a year” are yet to return and I have no reason to believe that the ones leaving now will break that trend. A recent BMA survey found that six out of 10 GPs were considering early retirement, while a quarter were considering quitting the profession.

Our GP-led telephone triage at the practice has begun to suffer with waiting time for a routine appointment about to hit four weeks. We have no resources left to recruit new GPs or employ freelance GPs to help with the workload, and quite honestly, there has been very little interest in the current vacancies because of the situation we are in.

My days are getting busier and longer, making it incredibly hard to juggle my working life and home life as a dad with a young baby. Crisis meetings about how we manage the workload/workforce imbalance are becoming more frequent, and sadly, I feel like I’m letting my patients down as their frustrations are increasing and the queue at the door is getting longer.

The result of all this is that morale is at rock bottom. We cannot plan for next month, as we simply don’t have any indication of the funds we will have at our disposal, and we cannot recruit more staff as no one wants to work in these uncertain times.

Sadly, what was a flourishing practice is withering away 
slowly. Try as I might, I’m
having to watch it happen. 
It is hardly surprising that another BMA survey found recently that GP morale has hit rock bottom.

We need to urgently address the issues facing general practice in order to ensure we can deliver the care our patients deserve. This means not more short term political gimmicks from politicians of all parties.

We need sustained investment to expand the number of GPs and other staff in local practices, as well as providing real support for GP services that includes bringing GP practice buildings up to scratch. Only through sustained reform and support will we pull general practice back from the brink.

DR Krishna Kasaraneni is a GP from Sheffield.