WEST Somerset is facing a recruitment crisis hiring GPs but although Harley House has five of its doctors approaching retirement age, Dr Sue Neville says she hopes the challenge will lead to exciting solutions which in the longer term could improve long term care.
"My husband, Dr John Higgie, and I have been GP’s in Somerset for over 20 years, and have had happy and fulfilling careers. We are committed to Primary Care in Somerset, and think it is a wonderful place to work.
I agree with Dr Davies that GP recruitment has been challenging in recent years, but hopefully that challenge will lead to innovation and some exciting solutions which in the longer term will actually improve patient care.
"First, recruitment. This is a national problem, which is slowly being recognised by central government. There are a variety of factors impacting on this; selection of applicants for medical training, exposure to primary care at undergraduate level, and experience of primary care early in medical careers. All of this is being addressed in various ways.
In Somerset, we have the issue of rurality - our younger doctors have trained in University towns, and have friends there , or have partners who are tied to city careers. There is also the factor that we actually need more GP’s simply to replace those retiring - the splitting of daytime from out of hours work , the trend towards portfolio working ( we are a good example of this - I spend a day a week teaching new GP’s, and John volunteers for Minehead Lifeboat as operations manager in his spare time), and the reasonable and sensible aim to maintain resilience through improved work life balance means that more practitioners are needed.
"In terms of retirement - yes, in our practice, five of our seven doctors are reaching “a certain age” , but we are currently planning to continue working for a while - we enjoy it!
"On the bright side, we are able to offer training posts to about 25 new GP’s in Somerset every year. After three years of a mixture of hospital and Primary Care placements we are hopeful that a good proportion of these will opt to stay in Somerset. Some will obviously move away, and some will work abroad, but they will have had a taste of Somerset, and may well consider returning to the area when house prices and family values become important to them. Our own son is a good example - he qualifies as a GP this year, plans to work in New Zealand for a short time to gain additional experience, but then hopes to return to the West Country. We are also in a good position to attract GP’s who have been working in cities and want to improve their work-life balance - the tradition of spending your whole career in one practice is fading, and we hope Somerset can capitalise on this.
"Finally, and most exciting, is innovation. We need to recruit and train colleagues in nursing and professions allied to medicine to help us, and to strengthen and broaden the Primary Care Team. Some practices now employ paramedics to help with home visits and emergency care, we have increased our Nurse Practitioner input and we are supporting them in becoming Nurse Prescribers. We can already direct patients with eye problems to the optician acute eyecare scheme, and in future patients with musculoskeletal problems may go straight to physiotherapists. We would like to work more closely with pharmacists, who can monitor treatments for long term conditions, and with social care, who can help us to look after those who are more vulnerable. Somerset Community Care Education Provider Network is actively working with local colleges to encourage Health Care Assistants to train for Primary Care, and investigating the availability of Physicians Associates - a new and very exciting healthcare role that one of our daughters is currently training for.
"From the users point of view, Primary Care will not, and should not, remain the same. You will still have a GP, but you will have access to a range of other healthcare support as well. So help us to help you. Keep healthy - eat well, exercise, quit smoking, drink in moderation. Attend routine screening appointments to help pick up problems early. Be aware of your own health issues, carry a list of your medication with you, and make sure you know which each one is for. Ask for a management plan - how often should you have routine check ups, or blood tests - then make a note in your diary, take responsibility for booking an appointment with the nurse in good time, and check on the results. Consider using other local services - for example the Pharmacy, Somerset Choices website, AGE UK, Somerset Fresh Steps Health Trainers - to get advice and keep well. Speak to the GP receptionist - they are able to signpost the most appropriate action. In future I envisage that patients will have a wider choice of practitioners to consult in Primary Care. They may see their doctor less frequently, but the GP will still be planning, supervising, monitoring and co-ordinating individuals care, and will be there when needed."