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Busy, busy, busy... it’s a day in the life of a GP

TAKING A LOOK Dr David Chilvers examines patient John Brewers foot when he visited Waterside Medical Centre, in Gosport

TAKING A LOOK Dr David Chilvers examines patient John Brewers foot when he visited Waterside Medical Centre, in Gosport

 

Doctors have come under fire for not being available for appointments.

And there’s a growing call for GPs to open for longer hours, in order to reach out to more patients.

The News visited Waterside Medical Centre, in Mumby Road, Gosport, to see what an average day is like in the practice.

We followed Dr David Chilvers, a practice partner, who works there three days a week.

There are 13,000 patients registered at the surgery, with four practice partners, and three other GPs that work.

It has various opening times, with the earliest being 7.30am, and closing at either 6.30pm, or 7pm, Monday to Friday.

The practice is currently closed at the weekends.

Appointments can be made to see a GP, or patients can use the surgery’s version of a walk-in centre, and wait in a queue until they are seen.

Dr Chilvers day began at 7.30am and finished at 8pm.

Below are highlights of the work he carried out in a day:

7.30am – Dr Chilvers comes to the practice and looks through test results and reports sent back to him. And sorts through prescriptions.

8.30am – Home calls are made to patients to offer immediate advise, and what to do next.

9.15am – First patient seen in clinic is 74-year-old John Brewer.

Patient shows blister on his leg and Dr Chilvers checks it with a magnifying glass.

Confirms it is a skin keratosis and uses liquid nitrogen to freeze it.

9.20am – 45-year-old male comes in with a number of problems. Complains of back and neck pain, swollen knees, a rash on his lower back, and red marks on his feet.

Dr Chilvers puts patient forward for an X-ray for his back, gives cream for the rash, advises on loose footwear and medicine for this knee.

Also offers stop smoking advice.

9.40am – 96-year-old woman comes in for a review to look after long-term heart condition. Checks medication, urine and blood pressure.

10.05am – 79-year-old man has airways disease, heart problems and blood pressure problems.

Comes to see Dr Chilvers about swollen feet.

While talking, Dr Chilvers notices patient has difficulty breathing, so requests a chest X-ray.

Checks feet and offers treatment.

10.25am to 11am – two more patients are seen, who have more than one long-term problem, and given treatment.

11am to 11.45am – 13 home calls are made.

11.45am to 12.30pm – meeting between Dr Chilvers, another GP at the practice, a nurse and an orthopaedic surgeon. Second opinion is sought on any patients, to make sure the right treatment is being given.

12.30pm – home visit paid to 85-year-old man in a care home. A type of cancer is diagnosed on the patient’s head, and a referral for removal of the lump is given.

1.30pm to 3pm – combination of two more home visits and calls to patients.

From 3pm Dr Chilvers works in the duty clinic.

This is where patients line up for an appointment on the day, and get seen on a first-come-first-serve basis.

In under five minutes, 11 people are already waiting to be seen.

By 7pm, a total of 54 patients were seen by the two GPs and the two nurses in the clinic. Dr Chilvers then stayed on until 8pm to finish off paperwork.

THOUGHTS ON DOCTORS WORKING SEVEN DAYS A WEEK

IT’S looking likely a seven-day working week for GPs will be introduced.

As reported, in October last year, prime minister David Cameron said GP surgeries should open from 8am to 8pm and over the weekends to fit in with the lifestyles of working people.

He also said a £50m pilot scheme would be rolled out across the country.

The announcement has proved unpopular with the majority of GPs, including Dr Tim Wilkinson, who works at the Derby Road Group Practice. He said: ‘There’s pressure on the current work force, and it’s not just the GPs that feel it. If we extended to seven days a week, we would have to pay for nurses, reception staff and electricity, for longer.

‘Of course, people can choose to go to A&E, but if it’s not urgent, then they should see their GP.’

Patient support group Portsmouth Healthwatch said extended hours should be placed to meet times of peak demand.

Manager Steven Taylor said: ‘Our view has always been that we support the introduction of more accessible services such as seven-day working, as long it is doesn’t impact upon normal services.

‘There is also the problem of having some services open seven days but others still restricted to five, meaning that some people will not be able to access all of the services they need. Wouldn’t a more open seven-day working week help people to forward plan more and offer more flexibility for families and working people to access their GP?

‘Having a more flexible service that’s more easily accessible over the full week would surely be a good thing, as long as the level of service was not to decrease.’

HOW MUCH DO DOCTORS EARN?

GP SALARIES vary depending on the number of patients registered at a practice, and the type of services it offers.

Doctors have always been self-employed practitioners, who mix private practice with contracted work from the NHS.

When the NHS was set up in 1948, GPs kept their independence but agreed to register all patients and provide 24-hour care.

They were paid on the basis of the number of patients on their books and payments for specific activities, including out-of-hours visits, maternity care and vaccinations.

In 2008, a new GP contract was drawn up, in a bid to stop doctors leaving the profession.

Under the new terms, it allowed GPs to opt out of providing out-of-hours care, and a performance-related pay system enabled GP practices to earn extra cash through the Quality and Outcomes Framework.

Sue Cross, practice manager for Waterside Medical Centre, in Gosport, said: ‘We have 13,000 patients registered here, and so we get a certain amount from NHS England.

‘Then we have enhanced services, such as chronic disease management, which gives more money.

‘That money is used to pay for the building, staff, nurses, and providing care.

‘What is leftover is shared out between the GPs, depending on how many sessions they have in the week.

‘We also have salaried GPs, who get an annual sum.’

Dr David Chilvers, who is a practice partner and holds six sessions a week, took home £3,700 last month. But that amount can vary, depending on the profit left over.

No cap is in place on the proportion of income GP partners can take as profit.

From April, payment through achieving QOF indicators will be taken away.

WHAT THE WEEK IS ABOUT

ALL week The News will focus on different aspects of healthcare available in the Portsmouth area.

The aim is to let readers know what options they have and when they should be used. People will then be given the chance to fill out a survey to help Clinical Commissioning Groups, who buy in health services and help them see what patients think.

There are three CCGs covering the area ­– Portsmouth; Fareham and Gosport; and South Eastern Hampshire.

Here’s what’s coming up:

· tomorrow – focus on out-of-hours services and pharmacies.

· Saturday – community providers and social services.

 

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