Editorial Comment

NHS General Practice is almost Unrecognisable?

The changes that are taking place in general practice surgeries are making the GP we knew in the fifties and sixties during the first 25 years of the NHS almost unrecognisable.  The surgery premises is no longer a cosy sitting room in a doctors house but a palatial building that is more like an office block or a church than a surgery.

No longer can you turn up to see your own doctor and just sit and wait. The whole attitude of both patients and doctors has changed toward expecting a ‘now’ service and providing an appointment sometime never. Patients expect to telephone a surgery and be offered an appointment with a doctor today. They are not always bothered about seeing their own doctor or the same doctor. Instead the service is driven by what is recorded on the GP Computer Record. Hopefully your treatment and care has been added meticulously by those recording your health care. But is the record of your attendance at an out of hours centre or your flu jab given at your local pharmacy recorded in your GPs notes. Did you get a look of disdain from your GP for going elsewhere?  Have your Lloyd George manual records been transferred and professionally summarised into your computer record? Have all the clinical letters received by the Practice been read and scanned into your notes and has action been taken where it needs to be?

The environment of the surgery is intrusive with pressing queues at the reception. No area to talk in private. Notice boards and leaflet racks galore filled with invites for this and that. The TV screen promotes a healthy lifestyle and your eyes are drawn to the Jayex digital display board to see if its your turn next. If your lucky when you log in at the faceless reception VDU screen you will be told how long you have to wait only to find that you miss the announcement due to an urgent call of nature.

Everyone is friendly and polite almost robotic. You are left feeling that you might have wasted someone’s time. Your surgery visits are now split into consultations with a doctor if you are lucky, a nurse practitioner, an asthma nurse, a diabetic nurse, and a health care assistant on phlebotomy duties. If I want to talk about a specific problem you need to raise it with the right person. I get a text message to remind who I am seeing and I get letter galore invited to this bit screened and that bit monitored. I could paper a wall.

All in all I wonder whether the service is any better. There are too many patients and too few doctors and nurses. The day is only so long yet GP surgery premises remain empty over 14 hours a day and for 62 hours at the weekend.  The lights may still be on but the computers are switched off. My call to ‘111’ results in a 12 mile journey to another town or a visit to a horrible A & E department filled with ‘sad souls’ suffering only from a heavy night out.

What is the solution? Perhaps it’s time to make sure that the service starts to deal with the person and not try to provide a range of services that only some need and not all can benefit from. The kitty is only so big and the cloth needs to be cut to tailor the  best suit.


Robert Campbell

By Robert Campbell<br><img src="" alt="Robert Campbell" class="avatar" width='50' height='50'/>

Started work writing medical cards in 1966 at Staffordshire Executive Council. Have worked at Inner London Executive Council, Hertfordshire Executive Council, Lambeth Southwark and Lewisham FPC, Birmingham FPC, Dudley FPC and Wakefield FPC and Family Health Services Authority. I was seconded to the NHS Appeals Unit and have worked as a full time GP practice manager since 1992 until 2010. I was also an AMSPAR trainer at Park Lane College, Leeds. Now I work as a freelance author.