This site is intended for health professionals only

At the heart of general practice since 1960

pulse june2020 80x101px
Read the latest issue online

GPs go forth

GPs are not a replacement for 'faltering ambulance service', say Welsh leaders

The BMA has been told to remind services GPs should not be a replacement for the ’faltering ambulance service’, following cases where GPs had to see newborn babies with sepsis because there was no ambulance crew available.

A motion proposed by GP Survival founder Dr Alan Woodall was passed at the Welsh LMCs conference last Saturday in Llandudno.

Conference members agreed to ask GPC Wales to remind health service providers, in particular Welsh Ambulance Service NHS Trust (WAST) and NHS 111 that GPs are not an emergency response provider.

The North Wales conference also passed the motion stating they believe that ‘[Welsh Government] and [health boards] must stop the practice of GPs being expected to attend emergencies outside of practices as a replacement for a faltering ambulance service and hospital overcrowding.’

There has been growing concern in Wales that GPs are being put under pressure to care for emergency patients by stretched ambulance services.

Dr Woodall gave an impassioned speech saying that GPs were expected to provide emergency care, often for several hours, due to a lack of ambulance supply.

He said: 'An email arrived from one of my fellow GPs in North Powys just this week pointing out that she had to see a five week old baby with a fever of 40 and saw them at around about 5.45pm.

'There was no ambulance available. The child was incredibly sceptic, temperature of 40, heart rate of 200, a cellulitic spreading rash, raised respiratory rate and capillary refill time of four seconds.

'The ambulance service had no crew to send, eventually an emergency response provider turned up who was no more help than anybody else that was available to provide care and eventually at 7.15 at night an ambulance did turn up to take the child to hospital. The child had sepsis.

'This is increasingly happening and increasingly GPs are being expected to provide emergency care and emergency response care, often for hours because of a lack of supply of ambulances in WAST.'

He added: ‘We cannot and must not be an emergency response service. We haven’t got the time, capacity the skills or the ongoing training to do this,’ he said.

Dr Alwyn Parry from North Wales LMC added that the current system was causing conflict and anxiety amongst GPs over how to deal with these emergency situations.

‘I can’t see that a GP is meant to add anything apart from superficially appearing to plug gaps in a service and place themselves at risk of criticism should things go wrong.’ he said.

Before the motion was passed BMA Plaid Cymru GP committee chair Dr Phil White reminded delegates that GMC guidelines did expect doctors to deal with certain kinds of emergencies.

But he added: ’I think that sometimes GPs are written into operating procedures by some people without thought.’

Dr Woodall responded and said the ‘catch-all’ situation where GPs became the ‘default dumping ground for any services’ inadequacies’ was no longer fit for purpose.

‘Patients will die and patients will suffer because we can’t be in three places at once,’ he said.

Readers' comments (5)

  • Where's Optimus?

    Awful situation with baby above ...
    not really our job to do so ..
    but think I would have just driven baby to A+E myself..
    If parents had no transport / taxi costs etc etc

    If No ambulance .. and where possible to do so
    why don't the ambulance service just order a taxi ??

    Yes we cant be in three places at once
    prioritise and cancel other none urgent work?

    Unsuitable or offensive? Report this comment

  • Where's Optimus?

    GMC protecting patients??
    but only remit is prosecuting the doctors who (are extorted to ) fund it.
    No one polices ambulance and other health shortages

    Unsuitable or offensive? Report this comment

  • Surely GPs are "ideally placed" in the community to proide these servies 24/7 ??
    But is the BMA ideally placed to ensure we are supported by other emergency services?
    Clearly not, because they have a conflict of interest.
    RCGP likewise.

    Unsuitable or offensive? Report this comment

  • Quite right. We are not a replacement for social workers, border police, plumbers, taxi drivers, psychiatrists, teachers and parents, filling in for lack of doctors in hospitals and part time psychiatrists.
    Taking us out of home visits will stop aome of this abuse of GPs.
    BMA, we want a focused limited role. Limits our risks and enables us to focus on what we do.

    Unsuitable or offensive? Report this comment

  • Yep. I gave up doing ooh when a 999 ambulance took 3 hours one night. One ambo on for the whole of Powys, and noone in Powys ambo control to even tell me when one could be expected!
    Not safe.
    Not remotely safe.

    Unsuitable or offensive? Report this comment

Have your say