‘I worry about patient safety when we’re under such terrible pressure’

Chair of the College’s First 5 Community Group Dr Toyosi Adeniji has written the following ‘day in the life’ op-ed for the Daily Express, detailing her experience as a frontline GP and the challenges she faces. 

I get into practice for 8.30am, I try to squeeze in some admin which includes reviewing blood test results but it’s never quite enough time and I need to get my first patient in. Consultations are 10-15 minutes long. In that time, we need to review their medical notes, talk through their history and symptoms, and start to think about next steps of clinical management.    

The patients we see have increasingly complex health needs. It’s certainly not just coughs and colds. Our patient population includes people with multiple, often chronic, conditions like hypertension, diabetes, and mental health conditions as well.   

With complex patients, we need time. Often 10 to 15 minutes just isn’t long enough. I want to be able to talk through all their symptoms and find out about their life – trying to find clues about what might be going on. I don’t want to just hand them a prescription and send them out the door. Sometimes, the appropriate management plan might actually involve a referral to our social prescribing link worker.  

Around midday we usually allocate time for home visits, where myself or other members of the practice team see a range of patients and this could also include providing end of life care. I’m back in the practice, seeing patients by 2pm. This is interspersed with questions or requests for advice from team members who I supervise. There will also be emergencies I need to jump onto to help sort out.   

I finish up seeing patients around 6pm and then the mountains of bureaucracy begin – often in my own time. There’s so much to do – and these aren’t simple tasks as they involve making clinical decisions like signing prescriptions, making appropriate referrals, as well as responding to various external administrative letters. Some GPs end up regularly working 12 hours days.   

Although what I have described is just a day, where clinicians are having to see and deal with 40-60 patients in some cases, the full week varies. I am personally a portfolio GP whereby I am also involved in medical education, delivering teaching sessions to our future GPs as well as medical leadership and management at various levels, which also requires time out for strategic meetings. This is in combination with looking after my family as well.    

I love being a GP, but I worry about the future of general practice. We’re being stretched so thin, and doctors are leaving. We need proper funding, without lots of caveats and red tape, to maintain our workforce.   

With more of us on the ground, we could get out into the community more, take a proactive approach and educate people on how to look after their health as this is the sort of thing that makes a real difference and contributes towards preventing people from getting ill to begin with.    

I do worry about patient safety when we’re under such pressure. Every day you’re making hundreds of decisions that have huge impact of people’s lives. I know my colleagues in hospitals are overwhelmed too, but the NHS wouldn’t survive without GPs working hard on the frontline.  

Further information

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Notes to editors

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.