Welsh GP leaders say they fear for the future of general practice in the country as a growing number of practices hand back their contracts because they cannot cope with mounting pressures.
The latest figures show the number of GP partnerships in Wales has fallen to 386 from 399 in 2020 and 420 in 2018.
An ageing workforce and increased patient demand since the pandemic has compounded a longer-term issue of practices being forced to hand back contracts to health boards, GPC Wales said.
Examples from primary care reported through an NHS Pressures Portal set up by the BMA to highlight the pressures in the system has found practices battling recruitment problems, rising energy costs, burnt out staff, and excess work dump from secondary care.
One respondent from Aneurin Bevan University Health Board said: ‘GP Practices in Wales are falling over, with many teetering on the edge.
‘We are facing the collapse of general practice in areas across Wales and there doesn’t seem to be anyone doing anything about it. I’m exhausted and not sure how much more I can take before I leave too.’
Another from Powys said an ongoing lack of communication by hospitals about patient appointments was putting an additional burden on GPs.
‘Appointments and dates for surgery being cancelled time and again and then patients are hearing nothing for many months. When they phone hospital they are told to see GP and ask for yet another letter to expedite their care.’
Previous research done by the BMA found that health board managed practices were 30% more expensive per patient to run.
Speaking with Pulse, Dr Ian Harris, deputy chair of GPC Wales said even practices in previously stable areas such as Cardiff were now at breaking point.
‘Warnings that we have been giving for a number of years are now coming to fruition. We’re really worried about the sustainability about general practice across large swathes of Wales.’
Most recently ‘startling’ pressures caused by strep A infections may be the ‘straw that breaks the camel’s back’ for some practices, he added.
‘The group A strep scare has really meant some GPs are evaluating how long they can keep offering the service.’
Dr Harris said they had a good working relationship with Welsh Government compared with colleagues in other parts of the UK, and a lot of bureaucracy had already been removed from the contract, but more needed to be done.
Ambulance delays and work being pushed back on GPs from secondary care were two very real problems for practices at the moment, he added.
‘We have an ageing workforce and we don’t have a pipeline of new GPs. Practices are also struggling to recruit allied health staff and receptionists.
‘Demand is inexorably rising and the workforce is shrinking and that is incompatible with delivering a service long term.’
Alongside investment in clinicians, there needs to be an ‘honest conversation’ with the public about what services can realistically offer, he said.