'Relentless and exhausting' – a day in the life of one of North Wales' under fire GPs

01.11.2021

A North Wales GP fears that ongoing public criticism, together with exhausting workloads is having a demoralising effect on NHS staff, as they prepare for their busiest ever winter.

Dr Nicky Davies, a GP Partner at Beech House Practice in Denbigh and Assistant Medical Director of Primary Care at Betsi Cadwaladr University Health Board, has appealed for the general public to be patient and understanding over the winter months, as primary care staff across the region tackle unprecedented demand.

Her plea comes amid criticism that GPs aren’t doing enough to offer patients face-to-face appointments and false claims that GP surgeries have been closed during the COVID-19 pandemic.

She has stressed that while General Practice had to change overnight at the beginning of the pandemic in order to maintain safety, primary care staff have been working and supporting patients throughout.

Dr Davies has shared details of a typical day in her life of a GP, to highlight the significant pressures facing primary care services and the impact that ongoing public criticism is having on its frontline staff.

“My GP day starts at 8am and finishes at 6:30pm at the very earliest, however I’m aware of colleagues staying until 9-10pm to complete the day” she explained.

“During the day I’ll have appointments with a minimum of 30 patients, through a mixture of telephone, video and face-to-face consultations, whichever is appropriate. There will also be around 20-30 additional telephone or administrative queries from patients. I am aware some GP colleagues deal with more than 80+ patient contacts per day, when the British Medical Association suggests between 25-35 consultations.

“I’ll also undertake home visits in between the morning and afternoon surgeries and review and action dozens of pathology results daily. We also review and action multiple prescription requests and complete medication reviews. We also find ourselves working hard supporting our hospital consultant colleagues when patients have questions about hospital care, appointments and waiting lists.

“On top of this there is additional paperwork such as support letters for patients, insurance and medical reports, all of which have to be fitted in to the general day.

“I don’t have time for a wee some days, let alone take a lunch break! I’ve been a GP since 2003 and this is the worst I’ve seen it. It’s just a relentless and exhausting day.

“Demand for care is up by at least 25 per cent compared to pre-pandemic levels and we’re grappling with the same unprecedented challenges as GPs across the country. These include the ongoing need for social distancing to keep staff and patients safe in Practices that are often small and unsuited to this need; Covid illness and isolation in staff and family; general staff recruitment and retention; reducing number of GPs; difficulties with long secondary care waiting times impacting on primary care; delivery of ongoing vaccination campaigns; dealing with Covid backlogs; and phlebotomy and blood bottle shortages.

“Despite these challenges we are continuing to offer face to face appointments when they are indicated. However, we do know that a lot of patients find telephone and video appointments very convenient because they don’t have to take time out from work to come in and sit in waiting rooms.

“We’ve even had a patient consulting with us while riding their horse, so convenience is a big thing!”

Dr Davies has appealed for people to be patient and understanding as NHS staff enter what is expected to be the busiest winter on record.

“Morale is very low because of this unfounded and upsetting criticism when we are working really hard to do the best for our patients,” she said.

“This is leading to some GPs leaving the profession which only compounds the problem. I really feel for, and thank, all my NHS colleagues who are working so hard.

“Please be patient with us. We appreciate it can be frustrating when you find difficulty in getting through to Practices on phone lines, but please bear in mind the lines are being used by our other patients, by our teams for telephone consultations or calling you in for vaccines or to discuss results. Please be aware we have other digital methods to contact us and there is lots of useful information on Practice and NHS websites.

“We are working really hard to do the best for our patients in very challenging circumstances. It is a privilege to be a GP and to be part of and help our community. But we do need public help and understanding, not unfounded criticism.”

For access to free health advice, 24 hours a day, including an online symptom checker, please visit the NHS 111 Wales website.

For further information on how to access the most appropriate healthcare services please visit the BCUHB website.