The NHS Crisis

There is no easy way to put this…


Everyone is aware the NHS is struggling.  Whilst the national media often chose to focus on ambulance waiting times, images of people of trolleys in A+E and the gargantuan hospital waiting lists, the reality is that the pressures on General Practice are even greater. Every delayed ambulance transfer, every prolonged stay on an emergency trolley and every patient waiting to be seen, operated on or followed up in hospital, has a knock on effect on primary care.  This leaves General Practice – and our local community – in a perilous position.


The reasons for the crisis continue to be argued over.  What is clear, is that Middlewood has been better prepared than most General Practices across the country.  We have been able to employ more clinicians across the four base Surgeries than ever before (yes, including before the merger), develop more efficient processes and safer structures than any of our individual Practice’s had in the past. And yet now, like every other General Practice, we are definitely struggling to meet demand.  And it’s not even winter yet.


The BMA recently produced a report on safe working in General Practice. It makes sobering reading.  In essence, General Practices across the country are managing millions more contacts every week with dwindling resources, and only vacuous guidance and little meaningful support coming from the Department of Health or NHS England. Every individual clinician working in General Practice in the UK, is currently having to attend to more patients each day than is recognised as safe – this situation cannot continue.  In the words of the conclusion to the BMA report, “…we want to be able to provide safe, high-quality care to our patients, without risking others or ourselves. At a time of unprecedented pressure and workload…we must undertake system changes within our practices, to preserve patient care.”


The somewhat draconian measures suggested in the BMA article, and indeed being adopted by some Practices across the country, are things we have sought to avoid throughout this crisis and actions that we hoped we would never have to countenance. However, it is clear that in order to continue to offer safe, effective healthcare, and protect the wellbeing of all our colleagues, we’ll need to make system changes as a matter of urgency.  This will involve, for example focusing our attention on those in need of urgent primary care and those with serious healthcare needs. We will be introducing new systems to help and everyone in Middlewood will continue to do everything within their capacity to accurately identify those patients who have the greatest need.  This will inevitably mean some people will be re-directed to services outside General Practice and some will have to wait considerably longer for an appointment.

Clinicians and patients alike find the current situation abhorrent – none of us asked for it, none of us want it.  Even more difficult times are ahead, but if we all offer each other mutual support, understanding and compassion and in time we will come out the other side.


Thank you for your support and understanding.

The Middlewood Partners