Plymouth doctor speaks out about struggles GPs are facing

A Plymouth doctor who fell in love with general practice has spoken out about the struggles surgeries are facing. The GP, who has long Covid, has said being a doctor is an “enormous privilege”, but that "crucial" funding is needed.

Dr Rachel Ali has over 20 years of experience as a doctor, the 45-year-old was previously a hospital doctor, but qualified as a GP nine years ago. She said that general practices have been "under-resourced" for at least 14 years and she, like other GPs, has had to cut down her hours due to being left with long Covid.

GP surgeries have “drastically changed” over the last decade, Dr Rachel Ali said, with things getting “more complicated, harder and longer every year”. She has also given some insight on why many people find it difficult to book an appointment swiftly.

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She said: “There are people in the country that could be working as GPs. There are trained GPs around, but we don't have the funding to employ them - because we've got to pay them. We're underfunded at GP surgeries.

“There’s a shortage of GPs working as GPs across the country. There are GPs who want to work, but the government needs to give us (the practices) money.

"When you call a restaurant to book a table and they can't fit you in, do you assume that that means they're not doing anything - or do you assume that that means that they're really busy.

“We are under-resourced and at some point it could mean that we have to turn the lights off, because we're small businesses, so to pay the bills, we've got to have the right amount of money coming in to pay the staff.

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These pressures have led to Dr Ali - and many other GPs taking something called collective action. Dr Ali said they are “not giving up any work that we are actually funded and properly resourced to do, but solely “working within our contract”.

She said “The problem is that the NHS for a long time has run on GPs doing a lot more than we're contracted and funded to do. Things that patients will notice a difference with are bits of work that we've not been adequately funded to do.”

They're called commissioning gaps, so aspects of work that have “never been funded for anybody to specifically do”. Dr Ali said that many tasks have “just fallen into general practice to take on”.

Dr Ali said: “We're giving three months notice to the commissioners to say, we need your help with this. Either they help us with this or we're going to have to stop doing it - and they’ll need to come up with a safe plan for patients.

“There’s been no capital funding for practices for at least 14 years - and by capital funding I mean the money for the buildings. So we haven't been able to upgrade our boilers. We haven't been able to fix holes in the wall. We haven't been able to replace faulty fix fittings and fixtures. Unless we take it out of the money that we should be spending on patients.”

Dr Ali explained that the reason there has been practice closures in Plymouth is because those surgeries simply "couldn't afford to keep the doors open".

She said: “We want our patients to be looked after safely. We want to give them the best possible care. That's all we want, but we’re not being resourced properly. It feels like every day there's another new thing being added to that pile of things coming out to us. We're struggling to do the work that only we can do because all, there's all of this other stuff happening. We need the time and the space to look after our patients properly."

Dr Rachel Ali said the "average working day" for a GP is 12 hours, "sometimes longer" with GPs having up to "70 patient contacts a day". She said that "medicine is changing" and doctors are seeing "more complicated blood results and more complicated conditions" especially as people are "living for longer".

In a statement on the One Devon website for NHS Devon, the public has been urged to "still come forward as usual for care during collective action by GP services".

The collective action started in August 2024 and is ongoing as the NHS "continue to work with government to find a resolution and end collective action".

Dr Amanda Doyle, NHS National Director for Primary Care and Community Services, said: “GPs and their teams are the bedrock of the NHS, and we recognise they are working really hard and dealing with record demand. On behalf of patients, the NHS has a duty to plan for collective action, and we will continue to work with government to find a resolution and end collective action.

“Our message to the public remains the same – they should continue to come forward for care during this collective action, as GP practices will remain open.”

NHS Devon also stated patients should continue to use 111 for urgent medical help when their GP practice is unavailable - and if it is a serious or life-threatening emergency call 999.