What is really going on with general practice?  Is the noise we hear from GPs every time we turn on the radio or pick up a paper rhetoric or reality?  Are GPs simply feeling the same pressure we are all feeling, or is something more going on? I decided to find out.

I know a number of GPs from my previous role as Chief Executive of the local Clinical Commissioning Group.  Firstly, I went to the surgery of Dr Tom Evans, a GP in Northamptonshire.  He is bright, motivated and extremely popular with both colleagues and patients.  I asked him what his life as a GP was like.

What I heard was alarming.  Tom’s day starts at 6.30 in the morning.  He personally undertakes as many as 150 telephone calls a day with his patients, as well as seeing many face to face.  He alone has the responsibility for the practice. Once the doors to patients close at 6.30pm he gets on with the growing bureaucracy that now comes with running a practice.  He gets home after 10pm most nights.

Most of us might imagine that the rewards for this hard-work would cushion any pressures he felt.  But then he told me about how the practice was doing as a business.  The surgery has been crippled by expensive locum fees for doctors, because despite advertising five times they could not recruit to the vacancy they had.  Ultimately he paid exorbitant fees to a recruitment agency to secure someone.  The surgery is now, in Tom’s words, ‘maxed out with the bank’, and he has to see his bank manager every two weeks. This means he has to pay himself less, just to keep the surgery going.

But maybe Tom is a one-off.  Maybe his situation is unique.  I couldn’t imagine that many would put up with that kind of continual pressure.

It turned out that I was half right, because while Tom may be unusual in his optimism in the face of adversity, his situation is not.  I visited another Northamptonshire GP, Dr Rick Byrne.  Rick told me frankly that he had had enough. At 57 he has made the difficult decision to retire on his next birthday.  It was clear from speaking to him that the pressure of dealing with the ever-growing workload is taking its toll.  And he is not alone; over a third of GPs now describe their current workload as ‘unmanageable’.

To the GPs it feels like no one is listening, and in many respects they are right.  I realised that, despite having been the Chief Executive of a CCG, I had never really listened to what the GPs were saying.  Sadly, I don’t think I am alone.  GP practices are small, independent businesses.  They need support, but because they are not a formal part of the NHS ‘family’ they don’t receive it.  Instead the weight of bureaucracy grows as quickly as the workload, while the funding barely moves.

As a country and as an NHS we need general practice to succeed.  I am going to do what I can to help.  Tom and I, with help from a panel of experts from up and down the country, have developed a programme of support (called ‘Practical Steps’) to help GPs resolve their current problems and strengthen general practice for the future. If we can stop GPs like Tom going bust and experienced GPs like Rick from leaving the service, then a positive future for general practice can still be secured.

To find out more about the Practical Steps programme contact Ben Gowland at ben@ockham.healthcare