4 minute read
Notes from a Modern GP
Notes from a Modern GP Dr Patrick Wynn
The NHS staffing crisis is not insurmountable, says Dr Patrick Wynn of Health Care First
We seem to have a world in in near apocalypse right now as we lurch from crisis to crisis. Only a year or two ago we had Parliament in turmoil over Brexit which paled into insignificance when the Global Pandemic came along. And just as we seem to be getting over COVID, there is a war in Europe. All of this puts our own problems into perspective, but it has impacted on our day-to-day clinical service in many ways.
We now find ourselves with a major sta ing crisis throughout the NHS. This is not just a lack of doctors which we always seem to focus on, but cuts through all ranks and roles. We don’t have enough sta available to pick the phone up when patients ring. This means long waiting times and we all know how frustrating it is sitting on hold, especially when you are unwell and have urgent needs.
Consequently, when callers do get through they are understandably annoyed and some will vent this on the receptionist they speak to, all of which is understandable but only makes the job of call handling harder and more stressful. This means we have yet more di iculty recruiting and retaining sta and, when combined with record low rates of unemployment, the problem gets worse. So many of our sta join the service because they genuinely want to help and do good, but who could blame someone for leaving if they are faced with an earful of angry callers day a er day when they could stack shelves in the local supermarket for the same money?
We rely heavily on specialist nurses who are highly trained to o er expert knowledge on specific disease areas and deal with all manner of urgent medical issues. These nurses are highly experienced and time-served before they take on extra responsibilities, but now we find the next generation are loath to engage with the extra training because they find it too academic and over-onerous. They simply stay at the same grade and do not attempt to progress their careers, and without the next generation of specialist nurses, we are facing a crisis of provision. We have introduced many new roles such as clinical pharmacists who deal with medication enquiries and can prescribe when required, and we are using specialist sta without the need to go through a GP or nurse. For example, you can now speak directly to an
NHS Physiotherapist without a referral. We have the funding to provide frontline mental health practitioners which is a desperately needed service but guess what- we can’t recruit!
Pension reform has meant that many older doctors are better o retiring and the increasing pressure in the system is making more and more doctors leave for nonPrimary Care jobs. The expansion of medical schools has in part happened, but it takes upward of 10 years to turn a high school leaver into a GP so the impact will take time to be realised.
Is there a solution?
What can we do to remedy this situation? Public sector pay rises have fallen way behind the private sector, but with a chronically underfunded service, is it right to take finance away from services to increase pay, or as a nation are we prepared to simply pay more for our NHS? This is in the hands of politicians and not something we can control directly or in the short term.
We can use agency sta or outsource services - I’m sure everyone is aware of online consultations with private providers such as Babylon. These providers can o er an excellent service whether privately or NHS funded, but at the end of the day they rely on the same diminishing reserve of specialist sta . Likewise with agency workers. In our district there has been funding to assist Primary Care with additional sta which has been used to hire agency sta - the irony is our own sta leave our service to work for higher rates of pay under the scheme with no net increase in service, just an increase in cost!
I believe we need a combination of many things. We need to improve pay without doubt, but that is not the most important factor in my mind. To improve our recruitment and retention we need to make the job more attractive all round. We need to improve working conditions in terms of relieving pressures and stress and in supporting the emotional needs that so easily get forgotten when working under pressure. With enough sta , support and funding, working in Primary Care could be the pleasure it once was.
Not only do we need to address sta numbers and training, but we also need to innovate and change working practice. The use of allied health professionals at the front line of service is one such opportunity we are already working on, but we need to go further with the use of online, phone-based apps and Artificial Intelligence solutions. This is just around the corner and can’t come too soon for me.
In my experience most NHS sta go to work for far more altruistic gain - to do good and help people. It sounds like a cliché, but it is true. On Sunday this week I was at the scene of a cardiac arrest giving chest compressions to an unconscious man who came round and started talking. He is now doing well in Coronary Care at the hospital and we are expecting a full recovery. Try and beat that for job satisfaction!
