HEALTH MATTERS: Day in the life of a Highland GP reveals demands of the job
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We’d like to share the stories of some of our NHS Highland colleagues, showing the huge range of careers available and how we work together as a team and with communities.
This week Dr Al Miles:
I’m a partner in an average-sized GP practice in Grantown-on-Spey (just over 5000 patients) in NHS Highland and a 600-patient dispensing practice at Glenlivet in NHS Grampian.
I work shifts for out of hours in Aviemore and chair the GP sub-committee of NHS Highland and the Highland Local Medical Committee. Through these roles I sit on various other groups.
I usually work around 56 hours per week, but sometimes as many as 80. This is spread over 2.5 days in Grantown, a day in Glenlivet, shifts in out of hours and a half day per week for committee work. The chair’s role is never just confined to this time and tends to eat into my spare time somewhat.
The pandemic has had a negative effect on most of society, and has certainly dramatically increased GP workload.
General practice has had to radically change how we deliver care as there has been no increase in funding, and there is a persistent and worsening national shortage of GPs.
0530: I get up early on week days to exercise. This helps me stay resilient to cope with the demands of the job.
0800: Arrive at work for the morning meeting. This involves the GPs, advanced nurse practitioners (ANPs), trainees, any junior doctors attached to the practice, and medical students to review any out-of-hours contacts or hospital discharge letters for our patients. Repeat prescriptions are signed at this time and complex cases discussed.
0845: Either drive to Glenlivet, start a surgery, or join the duty team of GPs and ANPs. We now triage most requests for healthcare. This is because many requests can be managed effectively over the phone, by one of the other types of professional in the practice (physiotherapist, pharmacist etc) or outside the practice (chemist, optician, podiatrist). This frees up time for face-to-face appointments for the problems which really need our skills. Video consultations are used if the patient prefers. Home visits are still made where necessary.
1100: Coffee break, if work allows, then back to work with the duty team, or start another surgery. The practice also has a minor injury unit, and provides a pre-hospital emergency care service. This is the time of day where a GP may have a meeting with other community health teams to discuss shared patients.
1300: Lunchtime, usually at my desk.
1400: Afternoon surgeries, or I might be still on the duty team.
1800: This is an opportunity to complete paperwork, referrals, results etc, speak to colleagues about difficult cases, or just catch up with people I haven’t seen all day.
1930-2000: Usually I get away home around this time and try to unwind before an early bed around 10pm.
Come the weekend, if I am not working for out of hours, I may try to get out with my camera – landscape photography is a therapeutic leisure (and minor commercial) activity of mine, but there has been very little time to indulge it since the pandemic started.
Otherwise, I can be found up mountains, or in lochs, busy not being a doctor!
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