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‘This town is hardly deprived. If they can’t find a doctor, what does that say?’

Doctors have told of their fears more GP surgeries in Greater Manchester will be forced to close due to a staffing crisis in the NHS. This week, Grove Medical Practice in Timperley announced it was shutting at the end of the September as bosses had been unable to replace a retiring doctor.

The surgery’s 5,700 patients will be transferred to three other practices in the area, further increasing pressures on an already strained system. Following the announcement, one senior doctor in Greater Manchester said he was ‘absolutely sure’ more GP surgeries will follow suit.

“We are now seeing the outcomes of a crisis that has been building up for the last 20 years,” he said. “More surgeries will close unless urgent action is taken.

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“We need to understand why doctors are leaving to go to places like Qatar, UAE, New Zealand – that’s creating a significant pressure on the system. We need to understand why we are not training and producing enough doctors.

“And we need to have realistic and honest conversations with the public about this. People always said it’s difficult [to recruit and retain doctors] in deprived areas, but Timperley isn’t deprived. If it’s happening there what does that say?”

According to the British Medical Association the NHS in England has lost the equivalent of 2,187 fully qualified full-time GPs since 2015. But, here in Greater Manchester, it’s a slightly different picture.

Grove Medical Practice, run out of Timperley Health Centre, is set to close. The wider health centre will not be affected(Image: Manchester Evening News)

The latest NHS figures show that last month there was the equivalent of 1,940 full-time GPs in the region. That’s actually up from 1,839 in June 2019.

But in that time the workload has also increased significantly. A growing and ageing population, cuts to community and social care budgets, the lingering effects of Covid and a drive to encourage patients towards their GP rather than A&E are among the reasons demands on general practice are greater than ever before.

Since 2019 the number of appointments delivered in Greater Manchester has risen from 1.18 million to 1.3million. And Dr Kamran Khan, GP partner at Unsworth Group Practice in Westhoughton and chair of Bolton GP Federation, says, that’s one of the reasons why it’s now harder than ever before to recruit new doctors.

“I don’t think there is any place in the country that doesn’t have an issue recruiting GPs,” he said. “The number of GPs applying for their first roles now compared to 10 years ago has significantly reduced.

“If you get three or four applicants you would be very lucky. In the past you were getting 15-20 applicants for each role.”

Dr Khan says the increased pressures on a full-time GP mean more and more people are leaving, while fewer trainees are willing to enter the profession.

The demand on GP surgeries is greater than ever(Image: WalesOnline/ Rob Browne)

“Because of the workload, because of the demands of the role, I think people that were thinking about retirement are bringing it forward,” he said. “Then if you are trainee and you see your senior GPs burnt out and demoralised you are unlikely to want to put yourself in the same position.

“So people are finding jobs elsewhere or they are locuming, so they are still doing clinical work but don’t have the extra stresses and strains of being a full-time GP with a practice to run.”

But while a reliance on temporary staff means appointments can be kept, it also affects the continuity of care patients receive. “We are providing more appointments but within that there’s less continuity,” said Dr Khan.

“Clinicians yearn for continuity of care . It’s probably the most important thing in general practice.

“But over the years there’s been a drive to improve access, but if you want an appointment straight away you can’t expect to see the same doctor – there’s just not enough people in the system.”

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Speaking last week Professor Kamila Hawthorne, Chair of the Royal College of GPs, warned GP numbers were ‘flatlining’ and called for urgent action to turn things around. “Winter will arrive all too soon and with it will come the peak season for our patients’ health issues and the additional pressures this creates for general practice,” she said.

“These latest figures show that we are far from prepared, with the number of full-time equivalent, fully qualified GPs continuing to flatline. The simple fact is that we need many more GPs to ensure that patients receive the care they need and deserve.

“General practice is understaffed and overburdened and we need to see policymakers take immediate steps to turn this dire situation around – introducing significant investment for improved retention initiatives to curb the rate at which GPs are leaving the profession and encouraging the next generation of GPs into the workforce.”

Speaking in July Dr Murugesan Raja, associate medical director for NHS Greater Manchester and a GP at Hawthorne Medical Centre in Fallowfield, outlined how he felt the situation could be improved. “It’s about making it a more lucrative place to work with investment in funding, estates and staff,” he said.

“We need more investment in deprived areas because they are ones that struggle the most. There are much more lucrative offers to work in the Middle East, in Canada. They need more GPs and the pay and workload is much better.

“Family ties and being invested in the NHS probably keep people here, but you can’t keep running on goodwill.”

But those kind of remedies require long-term, systemic change. In the meantime it’s people like Jo Hallows, who’s been a patient at Grove Medical Practice all her life, who are left counting the cost.

“I’ve been a fit and healthy person all my life, but now I’m having a few problems,” she said after discovering news of the closure on Wednesday. “I haven’t the seen the same doctor from one appointment to the next recently.

“A regular doctor would know all about it, but now you don’t feel like you’re really being looked after and they are not getting to the bottom of it. The staff here are brilliant and there used to be some really, really good doctors, but I know of five or six doctors that have left and found other jobs. It’s just very sad.”

Government research reveals that over the past five years, the number of permanent qualified GPs has fallen by around 5% (down from 27,600 in June 2018). However, when including locums, retainers and trainees, the total number of GPs has increased by 8%(up from 33,600).

The government says it intends to address health service staffing shortfalls through schemes like Health Education England’s Choose GP, and the NHS Long Term Workforce Plan, which promises that it would, if fully implemented, increase the permanent NHS workforce from 1.4 million in 2021/22 to between 2.2 and 2.3 million in 2036/37.

Regarding GP services, a Department of Health and Social Care spokesperson said earlier this year: “There are more doctors, nurses and staff than ever before working in the NHS, with over 500 more doctors working in general practice when compared to the same time last year.

“We’ve also delivered on our commitment to recruit 26,000 more primary care staff – such as pharmacists and paramedics – who work alongside doctors and nurses delivering direct patient care, a year early.

“And we recently announced £240million of support to GP practices across the UK this year to embrace the latest technology and make it easier for patients to see their GP.”