A Doctors Life
Find out more about what the doctors do
Dr John Graham Astles
MBChB DRCOG. Languages spoken: French, German
Dr Stephen Robert Borley
MBChB DRCOG MRCGP
Dr Nitin Joshi
MBChB DRCOG FRCGP. Languages spoken: Punjabi, Hindi, Gujarati
Prof Rishabh Prasad
MBBS MA MSC FRSA FRCGP. Languages spoken: English, Hindi, Marati
Dr Catherine Ellis
MBChB MRCGP PGCert (Hum.)
Dr Zahida Adam
BMBCh (Oxon) MA MRCGP DCROG PGCert (Pal.Ca)
- What does a GP do all day?
- Why don’t GPs work more sessions?
- Why don’t you have more doctors?
- Named GP
Medical work carries a significant administrative load. This is for your protection and to ensure quality of service. However, these tasks mean that contact time is often matched or exceeded by the required administrative time. You can get an idea of this below.
A day in the life
0730: Extended hours
Some doctors, nurses, ANPs and Healthcare Assistants will get in at this time for our Extended Hours offering.
0800: Getting in to work
The GP’s day begins the same as most peoples, with getting in, getting a coffee while grabbing any post or notices, then settling in to load up the PC. They then start preparing for clinic by looking at blood results for patients. These need to be in mind for patients that morning, and to action results for tests requested after appointments.
The government suggests 10-minute consultations. That means that GPs often see three or more patients per hour, and have to maintain both a high level of focus and a keen awareness of time spent.
Deal with paperwork from the clinical session. This may include dictating letters, checking notes, or arranging tests, visits or further clinical sessions.
We look after 4 times as many people aged 85+ as other practices. To put this in perspective, many GP practices provide around 2 visits a week, while we are often are asked to visit 20 people in a single day. These visits tend to be complex, dealing with multimorbidity (where a patient has multiple chronic conditions), care planning and end of life care.
1330: Practice Meeting (and lunch if you’re quick)
There are regular meetings at the practice, which are needed to ensure we are providing the best possible care. They cover issues such as educational topics, complex patients, referral pathways and administrative issues.
1430: More paperwork
Over the day, there will be about 50 blood results per doctor. Each of these which need to be carefully reviewed. In addition, there are often 350+ prescriptions that need signing, of which 50 or so will need a review of medical records before they can be safely issued.
1500 PM Clinic
This clinical session tends to be more difficult than the morning session, as people are often pressed for time, or have been waiting over the day for their appointment.
1830: Even more paperwork
More paperwork is generated from the afternoon session, and ideally needs to be dealt with before the end of the day.
There are several factors that limit the sessions we can offer.
- Complexity: As patients get older, with more complex problems, it takes more time outside of the clinic to ensure the best of care. Appointment times are still 10 minutes, but the added complexity can triple this in out-of-clinic time time needed to ensure safe patient care.
- Safety: There is a safe limit on the sessions that can be performed. Each patient needs proper personal attention, and time saved would not make up for compromising that care.
- Expertise: Many of the doctors at Willowbrook have experience and knowledge which is used to improve patient care at a national level. For example, Dr Joshi is a nationally recognised expert in health checks, and chairs a Leicestershire board to ensure that fewer people die from heart disease. Dr Adam is on the NICE board examining the latest in medical technology, and Prof Prasad has research and teaching responsibilities at De Montfort University. These skills ensure we offer the best possible patient care, but also mean that doctors have heavy patient-related workloads outside the practice.
- Sanity: Given the staffing crisis and funding pressures, it has become more important than ever for all staff to maintain a healthy work life balance. Doctors who work excessive hours burn out and offer unsafe care.
Cost: GPs see 90% of all patients in the NHS. But get about 9% of the budget. The practice is funded about £83 a patient, a level that has not changed since 2007. This must be used to deliver all of their care for a year, as well as support the practice costs and the practice’s costs such as heating, administration, and staff.
Demand: They way patients access care has changed. 10 years ago, patients saw a GP about ≈3 times a year, which has increased to ≈6 times a year. There are both physical and social reason for this, as the population ages and people become more conscious of their health.
Supply: A lack of investment in training our own UK doctors means we have only trained around 25% of the doctors we need. This means that it is a seller’s market for both local and international doctors, making it difficult to find the kind of long-term staff that are ideal as GPs.
Emigration: Given the pressures with the NHS, many doctors are choosing to leave and emigrate altogether. The shortage of doctors we are suffering is actually an international problem, with only about 40% of the GPs needed worldwide. As a result, skilled staff are emigrating, as they can earn more and work less in countries such as New Zealand, Australia, or Canada.
Retirement: A final pressure on GP numbers is that many GPs are taking early retirement, and that number is not being matched with increased intake. The overall funding crisis and change in patient complexity has led to a wave of early retirements that take much needed skills out of the system.
In summary, demand has increased, supply has reduced, and the funding has remained unchanged. It’s a perfect storm, and it’s why many practices are closing – and more are set to close.
The practice is required by the government under the terms of the latest GP contract to allocate all patients a named accountable GP. The practice does keep a record of your registered (accountable) GP. If you wish to be told the name of your accountable GP, please ask the receptionist when you are next in the surgery.
Please note: There is no need to telephone the practice for this information.
Having a named GP does not prevent you from seeing any other doctor in the practice. Your named GP will not be available at all times and you many need to book an appointment with an alternative doctor.
GP net earnings
All GP practices are required to declare the mean earnings (e.g. average pay) for GPs working to deliver NHS services to patients at each practice.
The average pay for GPs working in Willowbrook Medical Centre in the last financial year was £61,719 before tax and national insurance. This is for GPs who worked in the practice for more than six months.
NHS England requires that the net earnings of doctors engaged in the practice is publicised and the required disclosure is shown above. However, it should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice and should therefore not be used to form any judgment about GP earnings, nor to make any comparison with any other practice.