GPs 'beleaguered' by appointment bottleneck demand help

GPs in Wales have warned "rapid" investment is needed to help "beleaguered" practices cope with demand on services and cut telephone waiting times.

Doctors in some of the nation's most deprived communities said a decline in the number of practices had contributed to "choke points" for patients trying to book appointments.

A report by the Senedd's cross-party committee on health found an "8am scramble" for appointments remained one of the biggest frustrations for the public.

The country's health service is a devolved matter in Wales and will be a key issue for parties contesting the upcoming Senedd Election on 7 May.

The Senedd Health and Social Care Committee's report called for "bold action" from the incoming Welsh Government to ensure more services could be delivered by community GPs to ease pressure on hospitals.

It said access standards needed to be strengthened, reliance on time-limited booking windows should be reduced and continuity and communication between GPs and patients should be restored.

Peter Fox MS, who chairs the committee, said: "Delivering a truly community‑focused model will require bold action, and we must restore patients' trust in their local services.

"The message is clear, we cannot resolve the pressures in our hospitals unless we strengthen general practice and primary care."

Deep End Cymru, a grassroots network of GPs funded by the Welsh government, said there had been a fall in the number of GPs since 2015, while the number of hospital consultants had grown "exponentially".

Its chairman, Dr Neil James, a GP in Rhymney, Caerphilly, told BBC Radio Wales Breakfast the next Welsh Government should adopt a "more preventionist approach".

"It boils down to an issue of capacity. General practice has been underfunded in the past 10 to 15 years," he said. "There's twice as many hospital consultants than GPs."

James, who has been a GP for more than 20 years, said difficulties in accessing appointments was "heartbreaking" for both patients and GPs.

"The interface of the GP practice is so important for the community. When you have people queuing up to gain access in the morning, it's far from ideal. It increases the community's frustration, it increases pressures at the front desk.

"It is not a situation any of us want to be in. In communities like mine, in a very disadvantaged community, it's like firefighting, you have to manage the risk.

"If you're beleaguered, there's a point where it becomes risky for both patients and the doctors, which is part of the reason why you have these choke points at the moment."

He added that while advances in AI technology could potentially provide "short term" help to practices by streamlining callers to relevant clinicians, it could not solve the "fundamental issue" of capacity and funding.

"We have been pursuing an access-over-continuity model for the last decade at least, where access has been seen as a panacea," he said.

"Access is important of course but if you get continuity right, it's far more beneficial for patients and it will improve access in the long term."

Stacey White said she had recently tried to get a GP appointment but had been referred to the local pharmacy instead.

"You ring up at 8am in the morning and you're already number 40 or 50 in the queue," said the 39-year-old from Rhymney.

"By the time you get through they tell you it's emergencies only and to attend A&E, which as we all know, puts added pressure on hospitals."

Lisa Fisher, 47, said she struggled to get either a morning or afternoon appointment with her GP because the slots fill up so fast.

"I have a disability and my partner does; we're trying to get an appointment for my mother, she is starting off with dementia, and we can't get an appointment for anyone to see her," she said.

"It's down-heartening to see the way the NHS is going."

The main political parties contesting the election have responded to the report's findings and set out their plans for primary care in Wales.

A Welsh Labour spokesperson said GP practices in Wales received about 2.3 million calls but only 1.6 million appointments every month.

"Our government has brought in measures to manage the 8am appointment bottleneck and invested £12m to help GP practices build their capacity."

They said they were creating a whole-system approach, adding: "We're reforming the four national contracts - GP, dental, community pharmacy and optometry - to move care into the community, providing more convenient care and helping relieve pressure on services."

A Welsh Conservative spokesperson said the party planned to declare "a health emergency".

They added the party wanted to "improve access to GPs with a guarantee that patients don't have to wait longer than seven days for an appointment, increase funding for primary care every year and boost the proportion of NHS funding allocated to primary care".

Plaid Cymru spokesperson for Health and Social Care, Mabon ap Gwynfor MS, said the party would "look to restore funding to primary care, employ a 100 salaried GPs to ease the burden on secondary care, and improve access for patients".

They added it would bring "care closer to home and [shift] focus on health towards prevention to keep people healthier for longer".

Reform UK's Senedd Member for Brecon and Radnorshire, James Evans MS said Plaid-backed Labour governments had "neglected GP services, especially in rural Wales".

"We will reform the GP funding formula to reflect deprivation and rurality and improve equity of resource distribution, while alleviating pressure by expanding pharmacy clinical services so more care is provided in the community," they added.

The Welsh Liberal Democrats and The Green Party of England and Wales have all been contacted for comment.