Doctors warn that the Welsh NHS and general practitioners' offices are in danger

Dr Suhair Alwan

The British Medical Association (BMA) has warned that unless immediate support is given, GP services "will collapse in Wales and the NHS will follow" shortly after.

According to BMA Cymru Wales, as the number of patients rises, GP offices and doctors are becoming fewer due to a lack of funding and an unmanageable workload.

In a letter to the Welsh government, it begged for more funding and staff assistance.

Welsh officials claimed they were taking action to relieve GPs of some of their workload and to expand the number of services provided by neighborhood pharmacies.

The BMA said when it started its Save Our Surgeries campaign that the number of general practitioners in Wales had dropped from 470 to 386 over the previous ten years, an 18% decrease.

According to the report, the equivalent number of full-time general practitioners fell from 1,901 to 1,445 by 456 (21.7%).

In the meantime, there were 93,317 (2 %) more patients who had registered with practices.

All 386 GP practices in Wales were sent a BMA survey, and 240 of them responded.

It was discovered that 26.6% of respondents were thinking about leaving the field in the near future, and 80 percent of respondents feared that their heavy workload prevented them from giving patients quality and safe care.

In 2020, Dr. Suhair Alwan, a 40-year-old general practitioner, joined a Wrexham practice.

She quickly discovered that the pressure was "extreme" despite the fact that she considers herself capable of working under pressure due to the additional workload that comes with having a partner, which includes managing staff, resources, and her own patients in addition to administration and communication.

Dr Suhair Alwan
Suhair Alwan, the physician.

She stated that it changed from being the "most satisfying job" to the "most stressful job, which is sad to witness.".

Then, in June 2021, she claimed that the workload nearly took her life.

She was so busy that she chose to ignore what she believed to be flu-like symptoms.

I persisted, but I quickly deteriorated and spent 10 days in the hospital with sepsis, she said. "It was hard. I had a few moments where I believed that was the end of it and that I would pass away, leaving a young child behind.

About three months later, I became ill. Before it got that bad, I should have prioritized my health, but I was so fervent that I thought I had to fix what I could have fixed. I had hoped to make it until Friday when it was Monday, but on Tuesday, I was admitted to the hospital. ".

Following his recovery, Dr. Alwan returned to his position as a GP partner, but he soon discovered that the demands and pressures remained the same. She decided to leave the partnership.

The logical choice was to leave because although I was fortunate to survive this time, there's a good chance that won't be the case the next time. ".

Eluned Morgan
A cap on how many patients general practitioners can "reasonably deal with during a working day" has been requested by the BMA from Health Minister Eluned Morgan.

Dr. Alwan examined her prior workload after her "near-death experience.".

"I noticed that another colleague would interrupt me every five to six minutes to ask for my assistance in making assessments or authorizing specific decisions. without regard for my own clinical work or the time I spend with my own patients.

I felt that because of the interruption, both I and the patients I was caring for were in grave danger. Interruptions are a well-known cause and a dangerous source of error.

It was hazardous. Due to interruptions in the flow of thought, in the documentation, and in some processes, which can be fatal, it was putting these patients at a very high risk of things going wrong. While you're being interrupted by something else, it would take two seconds to administer the incorrect medication. ".

According to Dr. Alwan, GP partners are under so much pressure that daily mistakes could number in the hundreds.

"I believe the healthcare system is getting to the point where it is so dysfunctional that getting medical attention is almost pointless. It makes no difference whether you visit your GP or not if doctors are so disoriented that they make poor choices that, in some cases, could end patients' lives. ".

She is able to focus on patient care rather than the administrative tasks associated with managing a practice because she is now a self-employed locum GP in Flintshire and Wrexham.

She expressed the same worries about the future of general practice as the BMA. Without GPs, she claimed, "secondary care would collapse in a matter of days" as they were the "gatekeepers to the healthcare system and to secondary care.".

Dr Gareth Oelmann
The service is in danger, according to Dr. Gareth Oelmann of BMA Cymru, unless immediate action is taken to address workload, workforce, and wellbeing.

"This is currently an unsafe model," she continued. It's very sad to see because if it continues, the system will collapse and both patients and clinicians will be leaving it. ".

General practitioners committee chair for the BMA in Wales, Dr. Gareth Oelmann, stated: "I would anticipate that more practices will give back their contracts, and the pressures upon the service to continue providing in a timely and efficient manner are going to become more and more difficult without resolving the workforce issues, the workload issues, and the wellbeing of the staff in the general practice community.

"And ultimately, the general practice in Wales will collapse and the NHS will soon follow, if practices keep closing as they are. ".

Increased funding for general practice and a cap on the number of patients "GPs can reasonably deal with during a working day" were the two demands made by the BMA in a letter to Health Minister Eluned Morgan.

Additionally, it called for the implementation of a long-term strategy to enhance employee wellbeing as well as an increase in GP training, recruitment, and retention.

According to the Welsh government, there were 1,974 registered general practitioners in September 2022, up from 1,963 in September 2020. In 2017, there were 1,926 GPs working.

A spokesperson stated: "We greatly value the daily work done by GPs and all other healthcare professionals in GP practices.

"We continue to make efforts to lessen the burden on GPs, including the launch of NHS 111 Wales and a broadening of the services that community pharmacists can offer. The new unified GP contract will lessen red tape and give doctors more time to see patients.

"We appreciate the ongoing collaboration with BMA Cymru Wales as we develop solutions to long-standing sustainability problems in general practice. ".

The Welsh government figures, according to the BMA, did not account for GPs' full- or part-time employment.

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