Why is my GP waiting room still empty? Not because of lazy doctors, that’s for sure

Politicians have let us down badly, and the NHS and general practice is on its knees

Two weeks ago, a family member of mine went for an appointment at their GP surgery. When I asked them how it went, they replied that they didn’t understand why, if GPs were supposedly so busy, the waiting room was empty.

Now, for a member of my own family, to ask me – a GP of more than 20 years’ experience, and a senior GP representative for the British Medical Association – this question shows that there is a vast disconnect between what people see in their GP surgery and read in the newspapers, and the experience of doctors and practice staff working so hard on the ground.

Over the last two years, through the worst of Covid and beyond, GPs and our colleagues have read with dismay the headlines in certain media about practices “shutting their doors” or “refusing” to see patients face-to-face, implying that practice teams have been sat around twiddling their thumbs with nothing to do.

And now we’ve had headlines proclaiming that practices will be “named and shamed” in “league tables” as monthly data on appointment numbers, waiting times and whether they are face-to-face is published at individual practice level for the first time. The potential for further abuse of GPs, their staff and practices has increased even more and it has left colleagues fearful and angry.

It’s vital to stress that when the first wave of Covid-19 hit our shores in spring 2020, practices in England were told by the Government and the NHS to put in place measures to limit the spread of this deadly virus. This included introducing a “phone first” system – or total triage – and limiting in-person appointments to those which were suitable, safe and clinically necessary. Practices showed great initiative and innovation to change their processes overnight to keep their patients and staff safe. It was vital we did this to prevent spread of the deadly Covid virus in busy waiting rooms with unwell patients.

Fast-forward two-and-a-half years – in which time family doctors and their teams drove the world-leading Covid-19 vaccination campaign – and practices have never been under more pressure. The workload is crippling, and it can be hard to convey just how difficult things are.

We have a record-high waiting list for surgery and hospital appointments, and people who may have been put off coming forward for healthcare during the worst of the pandemic are rightly reaching out again. Adding into this a cost of living crisis that is having a dire effect on people’s mental and in some cases physical health, and GP practices are facing unmanageable demands.

In October 2022, practices in England booked more than 32 million appointments. That’s one for every other adult in the country, and the highest monthly figure since records began – yet we are constantly told we are not doing enough.

On top of this GPs and their teams delivered nearly 4 million life-saving Covid-19 vaccinations in their community.

But this was all done on the backdrop of a falling workforce, having lost the equivalent of 380 full-time qualified GPs in the last year – and a staggering 1,900 since 2015, showing how hard the remaining family doctors and their teams are working. GPs at the top of their game in their mid-fifties just can’t bear to carry on and are being forced to leave early – a huge loss of experience and knowledge.

The proportion of in-person appointments is admittedly still slightly lower than it was pre-pandemic, but 70% of appointments in October were face-to-face. And with such increased demand, any accusations that GPs are hiding away couldn’t be further from the truth.

So why is my waiting room empty, I hear you ask?

In any 48 hours at my practice, my team and I will deal with well over 1,000 patients, whether that is in the practice, on the phone, via video call or in their own homes. Then there are the countless letters, test results, phone calls to care homes or hospitals, forms and certificates, staff training and compliance, that all contribute to the care we provide in our community.

We manage some incredibly serious conditions and situations on a daily basis, from severe mental health crises, serious heart and lung conditions, and painful kidney stones to new cancer diagnoses and caring for patients at the end of their lives in their own homes. However, the waiting room may look empty at times.

Not all of the UK’s response to the pandemic was a success – from shambolic Test and Trace to the tragedy caused by patients being discharged into care homes without testing – but some of the changes in practices did enable us to think differently about how we improve ways of working to manage demand going forward and make the most of capacity while striving to provide patients with the care they need.

Not every patient will need to come into the practice itself, and many will prefer not to have to take a morning or afternoon off work to do so. Meanwhile, some conditions would be better seen by another professional such as a pharmacist or physiotherapist that may not be based in the surgery building.

We do of course try to offer a face-to-face appointment when patients request one. Far from being an obstructive gatekeeper, our incredibly hard-working receptionists, or care navigators as we often call them, are trained professionals who want to connect you with the right person and right service for your needs. They’re often managing a huge volume of calls, and the least we ask is that they are treated with the same respect and understanding they themselves endeavour to show patients.

We appreciate and understand the frustration that some patients have if they are struggling to get through to their surgery, especially at 8am, but the abuse that has been levelled against some staff – and reception staff particularly – over the last two years is completely unacceptable.

Fuelled by sustained attacks in some parts of the media, often backed by politicians, this hostility can have a profound impact on colleagues’ wellbeing and ultimately lead them to leave their jobs when we need to hold on to as many colleagues as possible.

So please consider this next time you read a headline about lazy or workshy “part-time” GPs who just want to knock off early to go to the golf course. Please direct your ire not at your GP, but at your MP. Politicians have let us down badly, and the NHS and general practice is on its knees.

Practice staff and patients are on the same team and despite the waiting room appearing less busy than many may be used to, there are dedicated staff going to great lengths behind the scenes to look after people. And I can’t even play golf.

Dr David Wrigley is a general practitioner and the deputy chair of the England GP committee