Chris Netherton, M.D.

Managing the unmanageable

This winter has seen an unparalleled period of pressure on GP practices across the UK, with the system showing major signs of strain.

Experts within the medical profession were predicting this long before it happened. A BMA survey of GPs in England conducted last year asked them how they were coping with their workload. The survey drew the following response.

It is a sobering thought that over two thirds of our practices are saying that, in effect, that they are unable to cope with their workload.

The NHS General Practice Forward View plan published in April 2016 has promised an extra £2.4 billion a year for GP services by 2024 and the addition of 5,000 extra GPs by 2021. However, as the government continues to put pressure on GPs to extend their hours, it is clear that the morale of some GPs is suffering.

Resilient GP, a support organisation for family doctors, believes that there is a danger of many doctors taking the “Plan B” approach and resigning from the NHS. In a recent Guardian interview, their spokesperson, Dr Michelle Sinclair, commented:

“Doctors are voting with their feet, either by going abroad or choosing a career elsewhere in medicine. Never has workload been so high, with so few GPs to undertake it. Plan B? Yes all the current talk is for a plan B.”

I have written in these pages before about how quickly GPs have embraced new technologies and new ways of working to try to manage this situation more effectively. The desire to enable them, at times, “to achieve the impossible” is what drives our business at Microtest and the teams that work here.

The General Practice Forward View highlighted a number of great ways in which more time can be freed up for doctors to spend on face to face patient care, such as:

  • Greater use of paperless systems;
  • More interoperability of systems to allow care providers to operate more efficiently and with a better level of “joined up care”;
  • Delegating more tasks to pharmacies and to nursing staff;
  • More use of telephone consultations and online triage.

All of the above are areas where Microtest is actively involved in supplying or creating the software tools that can help our GPs and their teams achieve more in their working day, while also improving the quality and accuracy of patient treatment.

Latest figures show that each patient visits their GP for an average of five consultations per year. So the biggest way in which we can relieve the pressure on our GPs is by only attending surgery for an appointment when it is really necessary. In that context, the General Practice Forward View touched on a very important aspect for improvement in the future:

“To support practices to offer more self-care and self-management processes.”

This will become a huge growth area for the future. NHS England already has a number of projects underway to look at the best ways of approaching self-management in the NHS.

Everyone has a doctor in him or her; we just have to help it in its work.


Everyone has a doctor in him or her; we just have to help it in its work.


One of the drawbacks of having a system that is free at the point of care is that it can make some people very complacent about caring for their health: “I don’t need to worry. If I get ill, the NHS will sort me out.” So one good thing that is emerging from our current situation is that it will stimulate people to take a much more proactive role with regard to their health, taking ownership and working in partnership with their GP, rather than being a passive recipient of care.

I am sure that self-care will be one of the big changes in society over the coming years. We urgently need this to happen in order to support the great work being done by our GPs. After all, it was the father of medicine, Hippocrates, who said:

“Everyone has a doctor in him or her; we just have to help it in its work.”