Pembrokeshire is downgrading and health declining, along with the doctor workforce……

Pembrokeshire is downgrading and access to health declining along with numbers of doctors. The Milford Haven based Pembrokeshire Herald, a paper not beholden to local government advertisements, is telling the truth in it’s reporting. There are recruitment problems in Tenby, Argyll (Pembroke Dock), St David’s, Fishguard, Goodwick and Winch Lane in Haverfordwest. Doctors have left or are planning to leave to other countries, or retire early. GP training recruitment is threatened as there are fewer appropriate training posts in Withybush as it downgrades…

22nd September 2015: GP shortage ‘caused by Withybush

PEMBROKE 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 and we 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….

…“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.

A letter from (Daniel Weaver on) the frontline Jan 29th 2015: LOCAL GP, Dr Daniel Weaver gave The Herald his view of what seems to be the annual crisis in A&E. The problem, he says, is not limited to Pembrokeshire: “The pressures on A&E, GP and the hospital are complex. We have a time of year, in the winter, when there are lots of severe infections both in the form of viral and bacterial infections. This means there are a lot more ill people out there at this time of year. “Added to this we have an ageing population with large numbers of frail elderly with multiple chronic illnesses, often on many medications.

“When these patients get unwell they can get very unwell quickly to the point of requiring hospital attention despite significant GP and district nursing input. “There are more resistant infections around year by year so some people end up needing intravenous antibiotics in hospital or become more seriously unwell despite strong antibiotics in community for instance.

“Apart from the fact that there are more infections around, there are still also all the usual A&E type problems occurring: for example, heart attacks; injuries; alcohol and drug intoxication. The same goes for General Practice. We have all the usual problems we normally see but with increased seasonal demand due to more mental health issues and infections in the winter months.

“A GP will often see up to 50 patients a day in surgery when it is busy in addition to home visits, analysing results, writing and dealing with letters to and from the hospital, arranging investigations, making phone-calls and signing hundreds of repeat prescriptions each week. Staffing is increasingly problematic in the NHS nationwide both for hospital departments and in General Practice, this is particularly problematic with A&E doctors as there is a worldwide shortage in this speciality.

“Wales (particularly rural Wales) especially struggles to attract doctors due to many issues, including lower pay then other parts of the UK; issues with airport/transport links; many doctors not wanting to work in rural areas; as well as, in more recent years, more barriers being erected preventing non- EU doctors from working in the UK.

I think there is a lot of work going on behind the scenes to find solutions and hopefully these will be successful. “I know people can get frustrated by delays within the NHS especially at this time of year, I share the frustrations but I also know how hard everyone is working throughout Withybush and in the community despite the ongoing pressures, and I am proud work alongside them and the public in my home county.”


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About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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