Seven days a week GP service a hot topic at Rural Primary Care conference

Consultant radiologist Dr David Parker took advantage of the October sun by leading an outdoor workshop on radiology in primary care at the Rural Primary Care Conference at Gregynog Hall.

GPs being asked to deliver a seven days a week routine service, Ebola, obesity management and sexually transmitted disease resistance were just some of the hot topics covered at this year’s Rural Primary Care conference in Mid Wales.

Organised by Montgomeryshire Medical Society (MMS) for GPs, trainee doctors, practice nurses and managers, the popular annual conference attracted more than 100 delegates over three days at Gregynog Hall, Tregynon, near Newtown.


A debate on the controversial subject of the Government wanting GPs to provide a seven days a week routine service was led on the eve of the conference by Dr Peter Holden, a Matlock GP and special adviser to the BMA General Practitioners Committee on premises, out of hours care and rural matters. It remained a talking point over the next three days.


Dr Holden, a GP for 32 years, warned that general practice in England and Wales was in danger of collapsing well before the next General Election unless the Government was realistic about its demands on GPs.


The only reason general practice continued to operate was due to the professionalism and dedication of GPs and their staff, he said.


MMS chairman Dr James Kiel, a Welshpool GP, said: “There is insufficient manpower to cover what we do at the moment without thinking about delivering a seven days a week routine service. We are struggling to meet the current level of demand. To try and expand the service is fanciful and unrealistic.”


Dr Michael Lewis, a Welshpool GP and the Powys Teaching Health Board’s continuing professional development co-ordinator for North Powys, said an extended hours routine GP service had been piloted in England and abandoned by many practices due to insufficient demand.



He said there were not enough doctors or nurses to provide a seven days a week routine service and new staff, such as pharmacists, physician associates and others, were being brought in to support primary care.


It was important that new recruits were properly trained for rural practice, where the range of services offered and conditions dealt with was greater than in urban areas.


Dr Lewis also referred to the threat of strike action by junior doctors in England over the Government’s threat to impose new contract conditions following a breakdown in negotiations. “The Welsh Government has said it will not impose the changes, which offers some hope for recruitment in Wales as doctors in training will have better conditions than in England,” he said.


The change is proposed at a time when General Practice is desperate for new recruits, as a growing number of experienced GPs are retiring or moving away. “General Practice and primary care are going to have to find new ways of providing services because we can’t get new doctors,”   added Dr Lewis.


He revealed that all the GP partners from one North Powys practice had left and Powys Teaching Health Board was finding other staff to keep it running, while several practices in the region already had, or were facing, a shortage of doctors due to the retirement or relocation of GPs.


Both he and Dr Kiel were encouraged to see a larger number of junior doctors attending this year’s conference. Both said they would welcome incentives to encourage junior doctors to opt to become rural GPs.


“Being a rural GP has a lot to offer, including quality of life, a greater variety of work and a choice of specialisms,” said Dr Kiel. “We need to recruit enough quality GPs or the system is going to collapse. GPs are the bedrock of the NHS and the glue that holds it together.”


He said the conference was valuable for its networking as well as its programme of quality education. Networking with like-minded professionals helped rural GPs to feel less isolated and part of a team.


“We have had excellent feedback about this year’s programme and the quality speakers,” he added. “The fact that a large number of delegates have been coming for so many years is testament to what the conference offers and it’s very encouraging to see so many young doctors this year.”

Other topics covered by speakers included the diagnosis and management of allergies and nose and sinus diseases, multi-drug resistant TB, microbes and the future of prevention and control, radiology and spirometry in primary care, managing rural trauma, integrating echocardiogram and heart failure services in the community, end of life care planning, minor surgery, diabetes, the hip joint and familial hypercholesterolaemia.


MMS was formed by a group of GPs to provide their own brand of rural postgraduate education in the 1980s. Previously known as the Rural Doctors Conference, the first one was held in 1990 and it has continued to evolve and develop to meet the educational needs of GPs and, more recently, their primary health care colleagues.