A recent survey* by BMA Cymru Wales has revealed that 91% of GPs are routinely unable to meet patient demand due to unsustainably high workloads affecting appointment availability.
The survey data which will be revealed to members of the Senedd at BMA Cymru Wales’ Save Our Surgeries event today also exposed an alarming 87% of GPs feared their rising workloads were impacting patient safety as Wales saw its 100th GP surgery close this year **
With 100 fewer surgeries for patients to turn to, GPs now see up to 35% more patients each, causing unsustainably high workloads and burnout with doctors forced to work less than full-time to survive.
Unsurprisingly, this is resulting in an exodus of experienced GPs, with over half (53%) of GP partners planning their exit in the next three years and almost a third (31%) of salaried GPs intending to work less than full-time.
With 80% of GP respondents expressing significant concern about the financial viability of their practice, the BMA’s GP committee in Wales is under no doubt that the closures are a direct result of sustained underinvestment. Only 6.1% of the NHS Wales budget is invested directly into General Medical Services (services provided by GPs), a reduction from 2005/06, when it was at 8.7%.
That’s why BMA Cymru Wales is calling on the Welsh Government for an urgent rescue package for general practice as part of its Save Our Surgeries campaign ***
This includes seeking a fairer portion of the NHS budget, safeguards to protect patient and GP safety with a national maximum standard of patients per day, a workforce strategy to improve the retention and recruitment of GPs and measures to address staff wellbeing.
The calls have been backed by 704 GPs who have signed a letter to the cabinet secretary for health and social care asking for immediate action to save general practice from collapse.
The survey* also showed that 73% of GPs would be prepared to take some form of industrial action unless immediate steps were taken by the Welsh Government to restore a fairer portion of NHS funding.
Dr Gareth Oelmann, chair of GPC Wales, said: “GPs from across Wales have shared their experiences with me, and we are all united in our fears about the future of general practice. GPs have told me about the impact on their own health and wellbeing and their huge concerns for their patients. It’s heartbreaking.
“With 95% of GP respondents to the survey telling us they feel negatively about the future of the service and some only giving it a year to survive, inaction is not an option.
“I’m afraid without a fairer portion of NHS funding, the situation is grave, and if general practice fails, the rest of the NHS will follow.
“Our patients are already seeking private healthcare because of the huge waiting lists in secondary care and we’re seeing this trend in primary care. Without immediate action, this inequity will only deepen, impacting on the most vulnerable in our communities.
“We know that if general practice was given a fairer portion of NHS funding for the wide-ranging portfolio of services we provide, the NHS in Wales would have a far greater chance of success, and most importantly, benefit patients overall.
“We’re asking for a rescue package to prevent further practices from closing their doors”.
Dr Rowena Christmas, Chair of RCGP (Royal College of GPs) Wales added:
“I have been a GP for 25 years. I love my job and feel incredibly privileged to be able to support patients through their most frightening times. It has become almost impossible to provide the caring, quality service that we all aspire to though.
“I am constantly saying sorry to my patients. Sorry that they had to wait weeks for a routine appointment with me, sorry that I kept them waiting past their appointment time, because every consultation now is so complex that no matter how hard I try I cannot run to time.
“Sorry that the ambulance has not come, that they must wait so long for physiotherapy, or to see the counsellor. Hour after hour I apologise for a service that is not as good as it should be. I cannot change this and so it is morally distressing.
“If we had the proportion of the NHS Wales budget we are asking for, we would have a sustainable general practice, with better access for patients, and time to offer holistic, preventative medicine. This would be good for patients and would alleviate pressures on secondary care.”
Practice managers agree, Mr Gareth Thomas (Welsh Lead for the Institute of General Practice Management - IGPM) said: “Restoring the proportion of the NHS budget spent in general practice is paramount to secure the long-term financial sustainability for GP practices and enable GPs and their teams to provide the level of access that patients expect and deserve.
“Now is the time for the Welsh Government to prioritise General Medical Services before it’s too late.”
Earlier this month GPC Wales chair Dr Gareth Oelmann wrote to the first minister requesting immediate action on the delay to the 24/25 GMS contract negotiations where he said “We are now actively evaluating all available options in the event of a dispute”
Read about our Save Our Surgeries campaign to find out more
Notes to editors
Notes to Editor
*In April this year BMA Cymru Wales surveyed GPs across Wales which aimed to gather information about the workforce, their wellbeing and workloads. The findings of the survey are available in the latest Save Our Surgeries report. (attached)
** 100 GP surgeries have closed since 2012 according to Stats Wales
*** BMA Cymru Wales is calling on the Welsh Government for an urgent rescue package for general practice as part of its Save Our Surgeries campaign, including:
1. A commitment to funding general practice properly, restoring the proportion of the NHS Wales budget spent in general practice to the historic level of 8.7% within three years, with an aspiration to increase to nearer 11% in the next five years.
2. Invest in the workforce of general practice to allow the implementation of a national standard for a maximum number of patients that GPs can reasonably deal with during a working day to maintain safe and high-quality service delivery.
3. Produce a workforce strategy to ensure that Wales trains, recruits and retains enough GPs to move toward the OECD average number of GPs per 1000 people. This must feature a renewed focus on retaining existing GPs and tackling the problems driving them out of the profession.
4. Address staff wellbeing by producing a long-term strategy to improve the physical, mental, and emotional well-being of the workforce.
Background on contract negotiations:
Contract negotiations for the 24/25 financial year have been delayed, leaving general practice in a precarious position once again.
Last year negotiations for the 23/24 GMS (general medical services) contract failed to reach a conclusion causing deeper cuts to services.
Case Studies: To request an interview please contact [email protected]
Here’s what some of the GPs surveyed had to say about the state of general practice in Wales
Source: BMA Cymru Wales GP survey data April 2024
It is not just that we GPs are overloaded every day but that all other services are failing: lack of ambulances, no social care, our referrals rejected repeatedly for pointless admin reasons, terrible mental health provision, overloaded A&E, closure of community hospitals and a health board either?
My health is terrible now- physical and mental- and I am retiring within 12 months- much sooner than I had planned. I am extremely sad to be leaving this fantastic job/vocation which I love, in such a parlours state.
The situation is beyond dire, and I have no hope the NHS can be saved. I am determined this job will be my last in medicine and I am only still going because I know the practice will close if I stop. I don't want to make staff redundant.
I have trainees finishing training who can’t get jobs, and practices desperate for them who can’t recruit because they have no money.
I am genuinely concerned about my personal physical and mental health. I am at my desk 12hrs daily. I feel I am slowly killing myself in order to maintain a functioning GP surgery.
The profession is at the most dangerous point in my 35-year career. I fear the damage being done now may not be remedied. I’ll be glad to retire but fearful of needing future health care.
In the last tax year, partner income fell by 50%. We can now no longer afford to get locums and have to operate at a level where we see emergencies some days but not routine requests. This is the only way we can operate safely.
I am genuinely scared for what the future holds, personally, for my patients and for the NHS.
At the moment I'm working two hours overtime every day and I am exhausted and feel I am not offering the service to patients they deserve. We are only human. I fear for both my license and my patients at the current intensity.
My workload is huge, my workforce is depleting and my well-being relies hugely on everything outside of medicine and my role of general practice. I think about my patients…where will they go for their healthcare if general practice falters?