‘GPs don’t want to work five days a week’

welsh

When it comes to general practice, Welsh health minister Professor could probably teach his English counterpart a thing or two. 

While health secretary Jeremy Hunt has driven junior doctors to strike and GPs to consider mass resignation, Professor Drakeford is advocating  ‘prudent healthcare’ and talking about cutting the working week for older GPs. In fact, Welsh LMC leaders recently voted down a call for the GPC to canvass GPs about mass resignation, in a demonstration of the better relations on the other side of Offa’s Dyke.

That does not mean the softly spoken west-Walian has no challenges. Wales is not immune from the GP crisis – indeed, North Wales has some of the most acute workforce gaps in the UK. Welsh health boards were accused this month by Welsh GP leaders of ‘double standards’ after it emerged NHS-run practices were paid an extra £29 per patient in some areas compared with GP-run surgeries. A BMA analysis last year revealed that 10 practices in Wales were under health board control after becoming unsustainable, with a further eight ‘at risk’. 

Professor Drakeford speaks to Pulse as the pressures on general practice in Wales continue to worsen, so what is his approach to addressing them? 

Pulse has been calling for emergency funds to be made available to support practices at risk of closing through its Stop Practice Closures campaign. The Welsh Government offered support to at-risk practices last year. How is that going? 

It took a while to agree mechanisms with the GPC, but we now have two or three examples of that process being triggered and completed. 

Powys, which is the most rural part of Wales, is where this has been tested to the greatest extent. Sometimes it’s just additional advice and support; sometimes it means getting extra hands on deck, and sometimes it means money. 

What else is needed?

We must do everything we can to attract people to come to work as GPs in Wales and then to retain their services. 

People do not want to go on working five days a week as they have in the past. And we have to find ways in which people who would like to go on providing [some service] are enabled to do that. 

We have 64 general practice clusters in Wales and they are a mechanism through which practices can provide a system of mutual aid and work across their boundaries to support one another. Clusters are new – they are at different stages of maturity – but I think it has been a very exciting first 12 months for them. 

What have you learned from clusters so far? 

I am very glad, looking back, that we took the decision to put money directly into the hands of clusters at the very beginning to give them an opportunity to respond to issues in their areas. It has been very interesting to see how they have used that money.

Probably the single greatest use has been in employing a new cadre of clinical pharmacists. We’ve got 50 now, there were none – more or less – this time last year. Healthcare support workers are the second biggest group we’ve seen. We’ve had clusters choosing to employ social workers, advanced practice paramedics and advanced practice musculoskeletal physiotherapists. I have been struck by the number of clusters that have used some of their money to bolster third-sector services. There is also a move towards social prescribing.

I think it is genuinely exciting, the range and quality of ideas we’re seeing. They are linked by a key principle: that our GPs are our most highly skilled and scarce resource. What we have to do is find new ways their time can be freed to do the things that only GPs can do. 

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