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GP shortage ‘caused by Withybush downgrades’

docsPEMBROKE residents have expressed concerns about reduced opening hours in the town’s doctors surgery as a result of a shortage of doctors. Since September 1, the surgery at St Oswald’s has closed at 1pm on weekdays. Until then, it had been open until 6.30pm on Monday, Wednesday and Friday. The surgery, a member of the Argyle Medical Group which also has practices in Pembroke Dock and Neyland, serves Pembroke, Monkton, and a number of outlying communities in the area. The surgery in Pembroke Dock will remain open from 8am – 6.30pm.

However, concerns have been raised about how the reduction of provision in Pembroke will affect elderly patients, or those with reduced mobility. Speaking to The Herald, Practice Manager for the Argyle Medical Group Juliet Goldsworthy confirmed that the reduction in surgery hours was a deirect result of staff shortages: “We’re two doctors down at the moment – its a common problem across Wales,” she said.

Safety was apparently a major consideration for the shorter opening hours. The practice was unwilling to let one doctor work at the surgery alone. “Its about managing the surgery safely andwe can’t do that at the moment,” Ms Goldsworthy added.

When we asked how long the staff shortage had been a problem for, she said that the staffing shortages were ‘relatively recent,’ though admitted that they had ‘struggled on’ over recent months. However, staff holiday time had meant that they were unable to keep the current provision. “The first doctor left about 18 months ago, and we lost another one 12 months ago,” she added.

“We have been advertising in national publications, but haven’t had any response. Accepting that the situation for patients was ‘far from ideal,’ she said that the problem was an all-Wales issue. Ms Goldsworthy confirmed that the practice had 10.75 FTE (full-time equivalent) doctors.

There are around 25,000 patients registered with the practice, which equates to 2325 patients per GP. Several years ago, the average number of patients per GP in Wales was 1640, and while Ms Goldsworthy said that this had risen to around 1900-2000, she still acknowledged that Argyle Street still did not meet these levels.

“Its not ideal – it puts a lot of pressure on both patients and doctors,” she added. Ms Goldsworthy pointed out that Argyle Street employed full-time nurse practitioners, who worked supporting GPs, as well as a full-time pharmacist who could ease the burden on doctors with work related to medication. “We were one of the first practices to take on a full-time pharmacist,”she added. “The health board seems to be looking more at approaches like this now. I understand that patients hanker for days gone by, but times have changed.”

With regards to the opening hours at St Oswalds, Ms Goldsworthy told us that if two new doctors could be recruited the situation would be reviewed after six months. At present, she said that the practice has been advertising ways for those unable to drive to attend the Argyle Street Surgery to travel there more cheaply.

“Services like country cars, and public transport can save people money on taxis,” she pointed out. Ms Goldsworthy emphasised that the surgery would still be open in mornings, and that hopefully people who would struggle to get to Pembroke Dock would be able to attend then. “We do visit a lot of people at home, if they are unable to get out. Our visiting rates are quite high,” she added. She pointed out that a shortage of GPs could lead to a continuing problem, because constant staff-shortages would lead to an increased workload, and the job becoming less attractive for medical trainees.

“There is talk of a ‘Golden Hello’ in Wales, but I’m not sure what is going to become of that,” she said. Concerningly, Ms Goldsworthy agreed with other commentators, including Simon Hart MP, who has previously said that a reduction in service provision at Withybush will lead to a knock-on effect on the county’s medical community.

“As Withybush downgrades and less doctors come to work there, their partners, who often used to work in surgeries won’t come here either, leading to the health community shrinking. We had a doctor who worked with us who was fantastic, but his wife worked in paediatric care, and when the department in Withybush downsized she had to move to Swansea to find work.

“There may also be issues with GP training at the hospital.” Speaking to The Herald, MP Simon Hart agreed that Issues faced by Withybush Hospital were a definite contributing factor in staffing problems across the medical community in the area: “From what I can discover there is a definite connection between recruitment and uncertainty over Withybush. For once the problem is not entirely about money,” he said.

“For the County to be able to attract Doctors and their families, they need to assure them that the services have a future and that there is certainty as far as their jobs are concerned. The Welsh Labour Government continues to fail in this regard and our county suffers accordingly.” We asked Hywel Dda University Health Board whether this was a fair reflection, and what if anything could be done to attract more GPs to the county.

At the time of going to press The Herald had received no reply. A spokesperson for Hywel Dda UHB said: “We would strongly urge caution when drawing ‘definite’ links between recruitment issues at a hospital and GP level as there is no absolute or clear evidence for this. GP recruitment is challenging across Wales, this is well documented, and we are experiencing this in areas across Carmarthenshire and Ceredigion as well as Pembrokeshire.

“Whilst we are taking clear actions to address recruitment at our hospitals, we have numerous responses to recruitment challenges at a GP level. For example, we are in the process of developing a Primary Care Support Team to offer support to Practices with workforce issues to which we have successfully appointed a GP clinical lead and three Advanced Practitioners, due to start shortly.

“We are also supporting the development of other roles that can provide patient care in General Practice working alongside GPs. For example, Argyle Surgery have employed a practice based pharmacist to support the GPs on a day to basis. This is alongside developing portfolio GP roles to increase the appeal of working in the Hywel Dda area to those wanting diversity within their role.”

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Dayne Stone

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