A lack of ambulance capacity in Wales has forced ‘vast swathes’ of GPs to provide emergency care themselves.
The BMA told Pulse that some GPs are driving patients to hospital or giving emergency care in ‘inappropriate settings’.
One LMC said GPs are having to leave their clinics to attend emergencies, or dealing with heart attacks or strokes via out of hours services because ‘there are no ambulances’.
Politicians have picked up on the issue too, with Member of the Senedd Jane Dodds calling on the First Minister to ensure the Welsh ambulance service is ‘robust’ in rural areas.
Ms Dodds asked the First Minister how GPs could be supported to ensure they are not ‘first responders’.
She said: ‘One of the issues that GPs are raising, particularly in rural areas such as mid and west Wales, is that they are sometimes called to provide that emergency response to attend to a patient in the community who should be getting an ambulance, in order to ensure that they have somebody with them, for example, and being able to give that emergency response.
‘But of course, GPs are not trained to provide that response.’
In response, First Minister Mark Drakeford said ‘an ambulance won’t always be an answer that can be mobilised immediately’ and that strengthening immediate responses for patients will require a ‘whole-system’ approach.
Welsh GP Committee chair Dr Gareth Oelmann said there is ‘chronic frailty’ across the NHS system and called for an end to ‘accepting this as business as usual’.
Responding to Ms Dodds’ statement in the Senedd, Dr Oelmann said: ‘Despite our repeated warnings, our fears have been realised and vast swathes of the profession are reporting instances like this or similar where they themselves have driven patients to hospital or provided emergency care in inappropriate settings due to the inability of the ambulance service and wider NHS network to cope.
‘This example highlights some of the extreme pressures facing NHS Wales and supports our call to the Welsh Government for an urgent rescue package to save general practice from collapse.’
He said general practice in Wales is ‘on the brink of collapse’ with rural areas ‘some of the worst affected’.
Dr Sophie Bennett, medical director at Dyfed Powys LMC, said the pressures on the ambulance service are having ‘a disastrous impact on patients’ who are waiting too long or ‘being denied’ ambulances when none are available.
She told Pulse: ‘We have examples in our area where GPs have had to leave GP clinic to attend an emergency in the local shops – this prevents them being able to see their pre-booked and, in many cases, already waiting patients as they have had to leave mid-way through the clinic.
‘We have had instances where GPs are attending calls that have been redirected to Out of Hours or minor injury units (MIUs) that GPs cover as there are no ambulances in instances where the concerns are strokes or heart attacks.
‘We are increasingly finding that patients will call the GP instead of 999 because they get told that there is no ambulance. GPs are waiting hours and hours – on some occasions until 9pm at night in a closed GP surgery with an unwell patient awaiting an ambulance.’
Dr Bennett highlighted the ‘enormous respect’ they have for paramedic crews who attend patients in the community, and recognised the ‘significant pressures’ the Welsh Ambulance Service is under.
There were similar reports of GPs attending emergency situations in Wales four years ago, with Welsh LMCs calling on the BMA to remind services that GPs are not a replacement for a ‘faltering ambulance service’.
At the start of this year, NHS England was reportedly planning for more ambulance crews to to redirect some calls to GP surgeries.
And GPs in London were asked to provide clinical cover for ambulance staff during the strike action last Christmas, but the BMA urged GPs not to step in.
The BMA has recently launched a petition calling on the Welsh Government to commit to a rescue package for general practice – Dr Oelmann confirmed this now has over 10,500 signatures.
The GPC walked away from contract negotiations with the Government in October due to the lack of a ‘credible financial offer’.
In an exclusive interview with Pulse last month, Dr Oelmann suggested this year could be the first time a Welsh GP contract is imposed.
READERS' COMMENTS [3]
Please note, only GPs are permitted to add comments to articles
Did the ambulance come and see the GPs patient do their admin and home visits? No. Thought not. Not part of your contract. Don’t do it
Be careful working outside of your remit, If something goes wrong, the wolves will come for you.
Used to be the norm in rural General Practice, when GPs routinely carried a lot more kit, and regularly left mid surgery to deal with an emergency call. But there always were medicolegal considerations which are mich harder to ignore now.