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GPs go forth

'We face the real prospect of significantly limiting patient access'

Continual cuts have left one GP in the unenviable position of having to cut staff, reduce patient services and even consider reducing the number of partners while trying to stave off impending burnout.

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We had to take these measures because of continual year-after-year cuts to the practice’s funding. The 1.25% uplift to the contract this year leaves at least a 4-5% increase in expenses. If you add to that the QOF targets that we won’t be going for because we think they are clinically unsafe and jeopardising the health of our patients, we can’t try to recoup funds there, so we have to make cuts elsewhere.

We have reduced administrative staff hours, we have not replaced a retiring member of admin staff and we are looking to make two other members of staff redundant. We also have not replaced a nurse that has left but instead reduced the hours we run our nursing service. We have had to look at the nursing services that are requested of us from secondary care, and we will be looking very seriously in the near future at GP time. We don’t have the option of not continuing the employment of salaried GPs because we believe in a full partnership model for our practice, so we don’t have salaried GPs.

My own take-home pay has decreased by between 4%-5% for the last five years. If that continues then we will face the real prospect of significantly limiting patient access and actually decreasing the numbers of partners we have. If you put together the continued squeeze on take-home pay with the increased payments we will have to make into our pension pot then that soon becomes unsustainable.

We have already had to reduce patient services. For example, we have cut complex wound dressings, which we were never resourced for, complex blood pressure monitoring in the legs and we are not undertaking ECG monitoring in psychiatric patients - something that had been passed to us from our psychiatry colleagues and we are now passing it back to them.

I don’t actually understand how the Government can be talking about increasing access to GPs. We are at capacity. On an average day I will see 35 patients, I will make four house calls and then I will try to piece in the meetings required of me from the contract and also running a business. I will typically start at 7.30 in the morning and never be home before 7.30 at night and I have a two-minute communte from my practice to my home.

I personally currently only work four days a week because I could not face five days a week. Myself and other doctors in my practice are really facing the prospect of who is going to break first, who is going to suffer burnout first. Working a four-day week is my way of trying to protect myself so I can continue to be the GP I want to be. It is not for money that we go into this, it is to provide excellent patient care and actually this undermining of the budget that we have to provide this patient care is really affecting all of us.

I fundamentally object to the ‘want’ culture that is being fed by Government, because actually we are only funded to cover the needs of patients and it is just chewing up our access left, right and centre.

Our anonymous GP is based at a large GP practice in east Scotland with more than 10,000 patients



Readers' comments (14)

  • The only solution to meet the needs of patients who have become consumers is to introduce some form of charge at the front door. Those being proactively managed for long term conditions could be exempted. This model works pretty well for the rest of the world by encouraging choice and competition at the wants end and active care for those with real medical need.

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  • We've taken an 18.5% cut in drawings this year after being static for 5 years. Consultation rates are up over that period, of course.

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  • I had a phone call from my surgery telling me I have to attend for numerous blood tests & follow up appointment with GP - no explanation given so asked for GP to call back & tell me...the new QOF standards mean anyone with a chronic condition listed (there are loads) & in the case of r.a., have to be risk assessed for cardiac risk, osteoporosis and mood....then have a face to face GP visit every 12 months at least...but, Mr Cameron, I see a Rheumatologist every 6-9 months who monitors my condition and is specially trained...WHY should a GP have to take on yet MORE unnecessary work on top of everything else?? I really feel for those in general practice - it is just a case of earning points for slavishly following the 'rules' - whatever happened to individualised patient care???

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  • We dont get paid for individualised care, we only get paid if we tick boxes, I am sorry you have to put up with extra appointments but give your dr a break and come in to get them done so at least he can get paid.

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  • Telling patients to come and have tests so GP's is completely unethical and neither is it informed consent.

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  • You describe working hard for 12 hours a day, four days a week. If my maths hasn't deserted me, that constitutes 48 hours a week. Hardly excessive...

    You could choose to spread that over five days but you don't wish to, which is perfectly reasonable. Everyone else works this hard, and for less remuneration. I think you are all a bit cushioned from reality.

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  • To anon 6.22pm
    Actually 48 hours of constant high pressure work without so much as a lunch break (if my own experience is anything to go by) plus admin at home, meeting and learning needs IS excessive, The fact that other unfortunate people also work excessively doesn't make it acceptable. Remember we are making decisions that can have serious repercussions.

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  • I think that most professionals would be quite happy with a 48 hour week, whilst making serious decisions. Many professionals choose to work their hours over fewer than five days. No crime in that. But stop whinging about it. It really doesn't sound that bad. If you want lunch, stop and eat it, but just like everyone else, you'll have to make up the time by staying later.

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  • Who let the Daily Mail mole in?

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  • How can GPs whinge about 48 hr weeks when there are people starving in Africa???

    Blah blah blah - Sod off back to the Daily Mail website you goon.

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