Letter to Editor

Letter to Editor

A Snapshot from General Practice in the UK  

         Layla Al-Ansari a  and Diyar Adnan Aref b 

Dear Editors:

General Practitioners (GPs) have an essential role within the communities they live in. GPs work as part of large multidisciplinary teams (MDTs) that all support the holistic care of any patient. Nurses, midwives, health visitors, pharmacists, physician associates, psychiatrists, and geriatric specialists can be included. They meet regularly to discuss cases and plan joint approaches to coordinate care packages.

General Practitioners primarily look after patients with chronic illnesses, seeking to ensure patients are as well as possible and their respective conditions are well maintained. Additionally, the GPs have an essential role in spreading awareness for specific diseases and encouraging patients to make preventative lifestyle choices via health promotion, with the initiation of treatment as a last resort; this can include clinics for child immunizations, smoking cessation, and advice on lifestyle during the GP consultation. GPs also have an essential role in safeguarding vulnerable children and adults and involving appropriate agencies if necessary.

Often being the first point of contact for patients with a wide range of potentially sensitive health problems, GPs must take steps to ensure all patient needs are met. Offering counsel to physical, emotional, social, spiritual, cultural, and economic issues through patient-cantered approaches is vital – yet often ignored part of a GP’s job. GPs see patients of all ages. Building an ongoing relationship with patients and offering continuity of care is one of the job's most essential and enjoyable aspects.

Depending on their examination and diagnosis, the GP has several management options they will discuss with the patient. Patients are often knowledgeable about their conditions. GPs will work with them to decide on a plan and give reassurance and further information while advising on a particular course of action or prescribing medication. Alternatively, they may refer the patient for other tests to confirm a diagnosis or as part of an ongoing management plan. These can include x-rays, blood tests, or referring for a second opinion.

Most critically, GPs are adept at spotting “red flag” symptoms, which might indicate a serious problem requiring further investigation and which needs to be acted on promptly.

In some cases, GPs must administer life-saving treatment. For example, patients may occasionally attend the GP surgery with an urgent, life-threatening condition, such as anaphylaxis (severe allergic reaction) or an asthma attack which GPs can help stabilize until paramedics arrive.

There are over 1.3 million GP consultations in the UK daily, typically within a GP surgery or the patient’s home. Less commonly, though increasing recently, GPs work as part of teams attached to hospitals with roles in accident and emergency centers, discharge planning, and unscheduled care (such as urgent care centers). In the community, they may run clinics in schools and residential and nursing care homes. A typical GP appointment is significantly time-pressured - scheduled to last for ten minutes. Since anything can come through the door, GPs must exercise swift and incisive decision-making based on the presenting symptoms and the patient’s medical history. As COVID-19 lockdowns were enforced, GP surgeries were forced to switch to online consultations. This change has remained in place, and now up to 40 % of a doctor’s consulting can be done over the telephone rather than in face-to-face consultations. This shift is likely to be exacerbated as technology and adoption improve in the future.

a General Practitioner, Keston Medical Practice, Purley, Surrey, UK

b General Practitioner, Bluebell Surgery, Colchester, Essex, UK