A Day In The Life...

Dr Paul Daniel, GP and Senior GP Partner

Much like many patients with a GP appointment I imagine, I approached the interview for this article with a long list of questions.

In response, Dr Daniel began by reflecting on how much has changed since he started work at the practice in 2005. With much smaller patient lists, GPs then had more opportunity to get to know their patients and provide that continuity of care which we all, GPs and patients alike, appreciate.

Today the picture is very different: a national shortage of GPs, more patient demand, hospital backlogs and of course, for SMC, the constraints of very cramped premises. I wanted to understand what actions were being taken in the circumstances to ensure a safe primary care service is maintained for patients living in Shipston and the villages.

Dr Daniel explained that one important change has been the expansion of the practice team to include a whole range of specialists, examples being Advanced Clinical Practitioners, Physicians Associate, Clinical Pharmacist, First Contact Physiotherapist, Social Prescriber and Mental Health Practitioner all complementing what the GPs and practice nurses are able to offer.

Some aspects of the GP role remain the same though. Time spent in consultation with patients still accounts for the largest part of what is often an 11-hour day (on average, seeing 35 pre-booked patients), but I hadn't realised just how many responsibilities GPs also have behind the scenes. Perhaps most obviously there are all the admin tasks associated with individual patient care, examples being interpreting and acting on test results, making referrals, responding to recommendations from secondary care, all of which can lead to many additional patient contacts each day. On a day that Dr Daniel or one of the other GPs takes on the duty doctor role, the total number of patient contacts can apparently double.

Less obvious is the clinical supervisory role GPs play within the practice. Dr Daniel described the support that they routinely provide to the expanded practice team, including the GP registrars (qualified doctors who are training in General Practice). Acting as a sounding board, agreeing treatment decisions where necessary, but also providing feedback to facilitate the learning and development of the whole team. I understood that this team working approach also extends to the GPs, again learning from and supporting each other to provide a high quality service for patients in what can otherwise be an isolated and stressful job. Apparently, the GPs also cover each other's admin workload during holidays or sickness which means there is no delay to ongoing patient care.

Returning to the need to respond to increased patient demand nowadays, Dr Daniel shared that one of the few benefits of the COVID-19 pandemic was that it had really forced the need to find new ways of working by learning to make the most of new technology. As an example of the latter, Dr Daniel explained that there are plans to introduce a fairer, simpler appointment system in the New Year.
The 'Triage First' system will bring a whole range of benefits regardless of whether the patient makes first contact with the practice by telephone, on-line, or by visiting the practice. It is anticipated that not only will this provide a better service for patients, it will also ensure that the practice team are being as efficient as possible. More information is to follow!

I asked if there were any updates on the premises front. Dr Daniel confirmed that discussions are ongoing with the Coventry and Warwickshire Integrated Care Board (ICB) looking at a compromise option of retaining and investing in the current building whilst renting additional space elsewhere.  Renting that space at the Ellen Badger hospital site remains an option.

Turning full circle, I asked Dr Daniel to reflect on how it feels to be a GP working in Shipston in 2023. He responded that the job is certainly much more pressured and that there is no spare capacity in the system but that at the end of the day working with the SMC team to provide a high quality service still provides plenty of job satisfaction. That and still having the opportunity to personally know and support as many patients as possible even if nowadays it means having to use technology to achieve that.