Contract negotiations between Welsh Government, NHS Wales and BMA Cymru Wales’s GP Committee (GPC Wales) have ended without resolution, leading to a stark warning on the future of General Practice from GP leaders.

Dr Gareth Oelmann, chair of GPC Wales, sent an open letter* to GPs across Wales announcing the development which said:

“The financial settlement on offer from Welsh Government did not match our reasonable expectation of an uplift to the contract value that would help to counter the damaging impact of soaring inflation on practice costs and staffing expenses. With no credible financial offer on the table and no tangible mitigations offered, prolonging the negotiation process would be futile. Unless there are any new and significant proposals brought to the table by Welsh Government, we do not foresee any further discussions on this year’s contract.

“Our Save Our Surgeries campaign lays bare the impact of long-term underinvestment in general practice and its consequent impacts upon workload, workforce and wellbeing. Despite the remarkable efforts of hardworking GPs in Wales, 80% fear they are unable to provide quality and safe care to patients due to their excessive workloads, diminishing workforce, and the rising demands on the service.

“We entered into negotiations in good faith, giving Welsh Government the opportunity to address these longstanding issues. We had hoped that through the contract negotiation process, we would reach a settlement that would put general practice in Wales on the right track.

“It will therefore be particularly galling to the profession across Wales that there is nothing resembling a ‘rescue package’ for general practice on the table. We have been absolutely clear that practices and patients will suffer because of it. We have urged the Welsh Government to reconsider and come back to the negotiating table with a credible offer that provides security and sustainability for practices and patients alike.”

The letter ended offering support to GP practices during the ‘crisis’ with guidance on how to prioritise safe patient care and steps to take before closing a surgery and handing back a contract to a health board.

Commenting on the announcement, Dr Gareth Oelmann said:

“Unless the Welsh Government can commit to a rescue package that begins to support GPs and their patients with the correct level of support then I’m afraid the GP crisis will only deepen in Wales.

“The unsustainable pressure facing GPs is felt up and down the country. We have heard from GPs who have been unable to recruit permanent staff for years on end, examples of extreme burnout causing hospitalisation and a rising number of surgeries having to close their doors as they struggle with bills and staffing expenses, leaving thousands of patients having to be treated elsewhere.

“There have been 84 surgery closures in the last decade. That’s 18% fewer surgeries available to patients with GPs taking on an unmanageable 32% more patients each.

“General Practice does not have sufficient funds for workforce, premises or services to meet the growing needs of patients. This is already undermining patient safety, and we are clear, without investment from Welsh Government, the future of the service is at real risk of collapse.”

ENDS

Notes to editors

Notes to editors:

* The full letter can be read here

The Save Our Surgeries report is available to download in Welsh and in English

Activity data for GP practices in Wales for 22/23: (Data source: GMS Wales GP Activity Data Quality Improvement project.)

• 27 million telephone contacts to surgeries
• 19 million appointments offered
• 56 million prescription items issued
• 1.3 million referrals to secondary care
• Over half a million Fit notes issued

Case study

Dr Kevin Thomas is a GP partner at the Pontcae Medical Practice in Merthyr Tydfil where he has practiced for over 30 years.

He said of the current pressures facing GPs:

“There's the common misconception that the contract is what we (GPs) get. And it of course it's not. We get what's left. And what is left these days is significantly less than it has been and shrinking all the time.

“We see lots of practices in trouble and we see practices who have handed the contracts back and they've walked away because they can't take the strain anymore.

“The issue is that we've all seen practices locally fold. It's a domino type effect. Those patients have got to go for care somewhere. It's the practices around that feel the ripples. The more it happens then you know you get not just ripples; you get a Tsunami that really can be destructive. So that's what we've got in front of us.

“The latest figure on the proportion of NHS funding provided to General Practice is shocking, keeping in mind we see 90% of patients in the service and we get 6.3% of the funding. You wouldn’t plan it like that.

“We are just expected to see 90% of the patients on 6.3% of the funding”.