Government efforts to address the recruitment crisis in general practice do not go far enough, writes Dr George Rae, British Medical Association North-East regional council chair and Whitby GP

THE landscape of general practice is changing. Having worked as a GP for many years, it is disheartening to see that the increasing pressure and demands of modern day general practice means the archetypal notion of the GP is changing. Patients no longer have the security they once had and the familiarity of a ‘family doctor’.

The recent announcement by the government to launch a pilot scheme across the North-East aimed at recruiting doctors from overseas is latest attempt at plugging the crippling doctor shortages in general practice.

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Whilst there is no doubting the valuable contribution that international doctors make within the NHS, like the many failed attempts of the past, this latest effort will not go far enough to permanently address the recruitment and retention in general practice.

In 2015, the government promised 5,000 extra GPs by 2020, yet the latest figures of the GP workforce in England shows only a marginal increase of barely one per cent. While we do need more doctors, this sticking plaster approach can only cover over the cracks for so long.

A recent BMA survey highlighted the seriousness of the issue with almost a third of GP practices in the North-East being unable to fill vacancies in the past year.

As well as the additional pressure being placed on staff at surgeries, GP shortages mean patients are having to endure longer waits and shorter appointment times. A recent survey carried out by the NHS looking at GP waiting times for patients revealed that in the area covered by Darlington CCG and Hartlepool and Stockton CCG, 18 per cent of patients had to wait a week or longer to see a GP.

In the worst cases, the impact of the recruitment and retention crisis has meant that surgeries have had to close their practice lists or shut down entirely.

In the village of Trimdon in County Durham, GP shortages have led to the temporary closure of the local GP surgery. This can of course have a devastating impact on patients, particularly the elderly and vulnerable, who are very much reliant on their local GP practice which serves as an important focal point of the community. It is a stressful upheaval for patients who may be inconvenienced further by having to travel longer distances to access care.

Sadly, this is a familiar picture throughout the rest of the country with NHS England reporting that the number of GP surgery closures in England in 2016 had risen by 114 per cent since 2014.

Rural practices have been hit hard by the recruitment and retention crisis in general practice as it is becoming increasingly difficult to attract doctors to these posts and the government effort’s to incentivise GPs and trainees to these roles has not gone far enough.

Cuts to public health funding is also having a knock-on effect on extra demand being placed on general practice. The release of the government’s figures on smoking cessation last week revealed that the North-East had the lowest smoking quit rates in England as cuts to the public health budget means less access to vital services.

With hospital wards and GP surgeries already struggling with the pressure of rising patient demand, any preventative services to tackle issues such as obesity, smoking, alcohol abuse and sexual health should be prioritised.

In a time where the health service is crying out for more stability and sustainability, the ongoing Brexit negotiations have created further cause for concern over the future of the NHS workforce.

This overseas recruitment drive seems somewhat counterproductive given the results of a recent BMA survey revealing that four in ten doctors were considering leaving the UK in the aftermath of Brexit.

If we are to avoid more years of surgery closures and the mass exodus of our GP workforce, the government must move beyond its sticking-plaster approach and provide the much needed investment to ensure the long-term delivery of a sustainable workforce.

It is of vital importance that the necessary funding is made available to not only train GPs but to ensure that general practice is adequately supported and resourced so that those doctors that do work here are happy and wish to remain working in the NHS.

The future of general practice hangs in the balance. The government must not allow for more patients and staff to be failed by an unwillingness to address the root of the problem.