A national shortage of GPs has hit Selkirk Medical Practice particularly hard. Five years ago, eight doctors were based at the town’s health centre. That number will shrink to three in six months’ time. Dr Aidan Cragg explains what impact this is likely to have, and how staff at the practice remain dedicated to delivering the best possible patient care...

EVERYONE is aware that the NHS has changed, most think not for the better. Selkirk Medical Practice has also changed.

When I joined the practice in 2018, eight GPs were based at Selkirk Health Centre. In two months’ time, when Dr Jeff Cullen retires after 29 years at the health centre, there will only be four of us. In July this number will drop to three, when Dr Rachel Mollart leaves the practice after more than 20 years.

This shrinking number of doctors is clearly not what we want, but having advertised the vacancies for the past two years we have been unable to fill the posts.

There is a shortage of GPs nationally, but more so in rural areas like the Borders.

So with 7,500 increasingly elderly and complex patients to look after, how can we hope to keep doing that with less than half as many GP appointments?

A much-needed addition to the team in recent years has been our growing number of advanced nurse practitioners (ANPs).

These are specially-trained nurses who can deal with any minor ailment or urgent condition patients might be unlucky to suffer, freeing up GP appointments for patients with more complex or ongoing needs. Believe it or not we miss seeing all the sore throats and spotty babies, which gave the job a wonderful variety. However, we can’t work like that any more: our limited capacity needs to be reserved for those patients who really need us.

To identify these patients, we trust our reception team to gather just the right amount of information from each and every person who calls the practice. This is not an easy job – remaining sensitive and not appearing too nosey is a fine art!

There are occasions when the receptionists’ best intentions are met with anger and even hostility, and I can see this takes its toll on them. They are a resilient, dedicated team that we couldn’t do without.

Other valued additions to the wider practice team are community pharmacists, as well as Rhys Evans, our physiotherapist. Their expertise eases the pressure on GPs, be it producing repeat prescriptions or assessing arthritic knees – and frankly they do it better!

Next time you have a sore shoulder don’t be disappointed when the receptionists suggest you see Rhys instead of a GP, he has the time and the knowledge to get it working again much faster than we could.

Unfortunately, there is no such remedy for the state of the NHS. My predictions on its life expectancy are gloomier than most wish to discuss.

I hope I am wrong.

However, until then, the remaining doctors, ANPs, practice nurses, district nurses and other caring professionals at Selkirk Medical Practice will keep doing their best to treat more with increasingly little.

In response to Dr Cragg’s words, NHS Borders said it was “exploring” a range of options to help tackle GP shortages, including an “innovative scheme”.

A spokesperson said: “NHS Borders is exploring a number of actions to support the recruitment and retention of GPs including the launch of our GP Fellowship programme – an innovative scheme to attract recently qualified GPs to the region.”

They added: “If you need support or treatment from our health professionals, whether you are on a waiting list or sitting in our waiting areas, out in the community or in hospital, please remember to be patient and be kind.”