Reaction to the BBC story that public satisfaction with GP services is at its lowest since records began.

Public satisfaction with GP services has fallen to its lowest level since records began in 1983, according to the annual British Social Attitudes survey. www.bbc.co.uk/news/health-43213896

As a GP I have experienced first-hand how the job has changed since I first started my primary care training in 1999. In the last 7 years our workload has increased by 16%. We are seeing more patients per day than ever, patients are consulting us more often, ands work that traditionally was done in secondary care is now being transferred back to primary care without the associated increase in resource that was promised. GPs are working longer hours just to keep up with the demand and the paperwork that goes with it. We now have to balance seeing patients face-to-face, speaking on the phone, fitting in time to sign prescriptions, complete referrals, deal with child protection meetings and forms, requests for insurance reports, and deal with a myriad of enquires from patients via reception. A typical working day is now at least 11-12 hours or more.

In light of this increase in workload, GPs are voting with their feet and leaving. GP numbers are falling – dropping by 0.6% in just three months from September to December 2017. There are now 33,872 full-time equivalent GPs serving a population of nearly 66.5 million in England. It is harder to recruit GPs and to find GPs willing to join partnerships where they are expected to stay in the same location and job for 10-30 years. This in turn adds pressure to those remaining. We are trying to transfer work to other healthcare professionals; practice nurses, pharmacists & paramedics, but there is not an endless supply available.

I still love being a GP; having a long-term relationship with my patients, seeing them deal with the physical, mental, occupational and social stresses that life throws at them and guiding them to either make positive changes that help them improve their lives or cope with these pressures as best they can. I still feel it is a privilege to be able to do this, and I do not want to see general practice turned into a procession of tick-box one-off encounters with patients we do not get the opportunity to build therapeutic relationships with.

What has this got to do with the Primary Care Society for Gastroenterology? Without GPs taking an interest in gastroenterology, the support and long-term management of conditions such as IBS & IBD will be lost. The ability to recognise that our patients “just don’t look quite right” and initiate investigations for anaemia, colorectal cancer or hepatitis . Who will recognise the impact that a significant diagnosis has on the patient and their family, friends, and education or work? Without primary care dealing with the overwhelming majority of healthcare contacts each day, the hospital service would collapse.

There are changes ahead that may make a difference – shifting work to community teams based around populations of patients to manage their long-term health needs, and moving the care of urgent short-term illness into hubs staffed by healthcare professionals with a range of skills is one way in which we can sustain the future of general practice.

There are interesting times ahead, and all organisations working for and with primary care need to work together to make the health service sustainable.