AThis month, a British Medical Journal (BMJ) investigation revealed that violent incidents at GP surgeries have doubled over the past five years.

Doctors, interviewed by the BBC, recounted being shoved, threatened and harassed on social media by patients who are frustrated and angry, blaming GPs for the long treatment waiting times and care backlogs that are out of their control. 

The investigation also found a large increase in malicious emails, and that incidents of stalking and harassment at surgeries and health centres rose from 85 in 2017 to 223 in the last year.

These shocking statistics highlight the unacceptable reality facing doctors in Wales on a daily basis, a situation which - as a surgeon - I have seen taking a heavy toll on my colleagues’ mental health, wellbeing and morale.

But with treatment delays and access barriers exacerbating patient aggression, this situation is a symptom of a wider crisis in the Welsh NHS.

Action is urgently needed to protect GPs, but to do this, leaders must first focus on tackling the roots of the crisis. 

Earlier this year, GP Dr Emma Hayward told MPs that working in general practice was like “being pelted with rocks, because you never know which rock is going to come and hit you hard”.

And speaking at a conference the following week, chair of the General Practitioners Committee (GPC) Wales, Dr Phil White, argued that the profession has reached crisis point, with pressures overwhelming staff, despite the fact that GPs had ‘given everything to weather the storm’ triggered by the pandemic. 

The number of GPs in Wales, as across the whole of Britain, is falling fast, as trainees are reluctant to move into new positions and existing doctors seek to retire early or reduce their hours to cope with unsustainable pressures.

This means that there are fewer frontline points of contact for patients, fewer clinicians to take appointments, and a decreasing number of veteran practitioners to manage the system. As post-pandemic patient demand remains high, Welsh general practice is in the midst of a perfect storm. 

Dr Phil White has also warned that, if general practice is not rapidly provided with additional support and resources, secondary care services could be buried under a "tsunami of work".

Based on my own professional experience, I second this warning: I have seen first-hand how vital the oft-underappreciated work of GPs is in the smooth running of the entire NHS. 

The National Wales: Owain Rhys Hughes.Owain Rhys Hughes.

Ambitious targets have been set for GPs to deliver more care, cut waiting times and prevent patients slipping down waiting lists. But without adequate resource provision and appropriate support, such targets are unhelpful - increasing stress levels and absorbing the attention of practice managers. 

To prevent system collapse and to strengthen the NHS for future generations, reinforcing the front line is essential.  Of course, we need more GPs - but recruiting and retaining them will only become easier when the conditions under which they must work are made less stressful and dangerous. 

There are several ways in which this can be achieved. Firstly, a zero-tolerance approach to any form of abusive behaviour from patients, coupled with training for practice staff on how to remain safe and access help when faced with a threat in (or outside of) the workplace.

Secondly, seeking out and investing in proven solutions to streamline workloads, improve efficiency and increase care capacity.

The past decade has seen siloed ways of working become entrenched, and poorly-designed tech systems eat up clinical time.


We need to break free from these outdated practices, and focus on widening access to community-based treatment services and on supporting collaboration between primary and secondary care colleagues.

By accelerating the roll-out of digital triage and referral platforms, the most labour-intensive work can be automated and streamlined. There’s also a need for the creation of new pathways for the public to engage with the NHS, alleviating some of the demand from GPs. 

Most importantly, it’s time we gave full recognition to the invaluable work that GPs perform in Wales. The public perception that it’s the "fault" of GPs that waiting lists are growing is both inaccurate and dangerous. 

NHS leaders must listen to GPs and deliver them the tools and solutions that will make their jobs manageable again.

Doctors want to deliver exceptional care under safe conditions; the focus must be on enabling them to do that. 

Owain Rhys Hughes is an NHS doctor from Ynys Mon and the founder of healthtech initiative Cinapsis a clinical communications platform for GPs, paramedics, NHS 111 call handlers and optometrists

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