'˜We need more resources', says leading Yorkshire doctor Richard Vautrey

As fears grow among family doctors over the future of their profession, GP Dr Richard Vautrey has been at the centre of calls for more funding and resources to meet rising demand on services.

In between seeing patients at his busy Leeds surgery, though, he is keen to voice his continued enthusiasm for general practice and its place in the community.

“I always wanted to be a GP,” said Dr Vautrey. “You never quite know who’s going to be coming through the door next. You see everybody, from the first day of a baby’s life to people needing care at the end of life.

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“The GP practice is at the heart of the community. People really value that.”

But being on the frontline at a time of growing demand on the NHS means doctors are feeling the strain of a system under pressure.

“The biggest challenge we have is constraints on resources,” Dr Vautrey said. “I think the biggest impact on individual GPs is the workload pressures because they have effectively unlimited demand and access to them.

“They are expected to see everyone and anyone who seeks their help in the working day, and that working day is just extending and extending.”

Dr Vautrey, who practises at Meanwood Health Centre, is a leading member of the British Medical Association (BMA) and chairs its GP Committee.

He is often quoted as the voice of family doctors at a time when concerns are being raised that frustrated GPs are leaving the profession and trainees are discouraged from joining.

When the latest NHS workforce figure were published last month, the BMA pointed out that it showed 200 fewer full-time equivalent GPs working on the front line than in September last year.

NHS England has pledged an extra £2.4bn a year for general practice and 5,000 more GPs by 2021.

The GP Forward View includes 3,000 more practice-based mental health therapists and 1,500 clinical pharmacists, and sets out plans to help GPs suffering from burnout and stress.

Dr Vautrey said: “I think there’s great frustration among GPs nationally that the government and NHS England are not taking the issues and concerns more seriously.

“There are pledges to increase investment in general practice but it is by no means enough to deal with the real fundamental problems that we face. So I think there is a significantly low morale in many areas.”

Latest figures show that 280 GP practices in England either closed or merged with each other in an 18-month period, including 37 in Yorkshire and Humber.

In many areas, large numbers of GPs are close to retirement. Some doctors are opting to become salaried GPs instead of practice partners who are responsible for running their surgeries.

Dr Vautrey said: “We know of a number of practices where doctors are not wanting to become GP partners and take a share in the business, simply because of their fear of being left liable for the premises.

“You don’t expect a hospital consultant to buy into bricks and mortar of the hospital building.

“That’s happening in some areas, where increasingly, doctors are choosing to be salaried because they can limit their workload into a more defined level and they don’t have the liability in the same way as a practice partner.”

But he added: “My concern about that type of model, though, is that we would lose what is at the heart of general practice at the moment, which is that long-term commitment to a local community, that continuity of care than you can offer.

“I think there’s a risk that we would lose that if you move too far away from the current model of general practice, which is actually been very effective of the last 70 years of the NHS, and on many ways has been the foundation on which the rest of the NHS is built.”

Whatever the long-term future holds, the day-to-day pressures facing family doctors continue as they address the needs of their patients.

There is an increased emphasis on mental among policy makers, but frustration on the ground at long waiting lists for psychological therapies.

Dr Vautrey said: “The reality is we don’t have enough people, enough therapists and enough resource to really deal with this rise in need that’s out there.”

The effects of precarious employment, rising living costs and changes to the benefits system are also being seen on a daily basis by GPs.

Dr Vautrey said: “I think as GPs we are seeing more people with stress, with mental health problems. Often patients who are really worried about losing their benefits and the impact of changes to their benefits are coming to their GP as the first port of call. We see the impact on people who are under huge pressures in the workplace, resulting in them becoming burnt out or stressed as a result of that.”

Despite the growing pressures on the GPs he represents, Dr Vautrey remains positive about the future as the health service approaches its 70th birthday.

But he warned: “I would hope that we can get the message across to government that if general practice fails, the NHS fails. That we need to recognise that investing in a community-based service is by far and away the most effective way to lead to a sustainable NHS for the next 70 years.”