Back in 2019 I wrote about Jack Leach’s now legendary contribution of one not out in the last wicket partnership he shared with Ben Stokes in the Ashes test match held that year at Headingly. Together the pair put on an exhilarating 73 runs and brought about an victory for England that had seemed unlikely when Leach had first walked out to bat.
The perhaps all too obvious point of my blog was to simply highlight how seemingly small contributions are every bit as important as the more obviously headline grabbing performances of others and how, whilst general practice might not seem as glamorous or spectacular as some other aspects of medicine, the countless small interactions that take place in primary care each and every day are, nonetheless, highly significant in the provision of good healthcare in the U.K.
In short my point was that, just as without Jack Leach’s one run there would have been no win for England over Australia, so without general practice, there would be no NHS. As such, despite their seemingly more humble efforts, those working in primary care should not underestimate their value in the exceptional efforts of the NHS as a whole.
That blog entitled ‘For when we can’t see why’, can be read here.
Now, whilst I continue to stand by all that I wrote back then, three years on there is something more that has to be said. Because last weekend, in another test match at Headingly, this time against New Zealand, Jack Leach shone once again. But this time, rather than his being a small but crucial contribution to the teams collective effort, his was a match winning performance in its own right, one that, by his achieving his first ever ten wicket haul in a test match, he earned himself the Man of the Match award.
I guess you could say that the bespectacled slow left armer played a blinder!
And it seems to me that general practice is putting in a career best performance too.
Obviously I exclude myself in that assessment and not solely because I’m contributing nothing to the cause at present, holidaying as I am in the Lake District. But whilst I’m wasting my time dodging the somewhat inclement weather and trying, unsuccessfully, to pen humorous verse, my friends and colleagues up and down the country are continuing to pull out all the stops as they endeavour to care for patients despite the toll that has been taken as a result of what has undoubtedly been an exceedingly difficult couple of years for primary care.
Like Jack Leach who was diagnosed with Crohn’s disease at the age of 14 and consequently takes immunosuppressive medication, general practice is currently clinically extremely vulnerable. Despite governmental promises of additional doctors in general practice, the number of fully qualified full time equivalent GPs currently stands at 1,662 lower than it did in 2015 and, with an increasingly demoralised workforce partly made up by doctors, 80% of whom report having suffered from anxiety, stress or depression in the last year, it isn’t surprising that a third of GPs are looking to leave the profession in the next five years. If that predicted exodus does indeed take place without the necessary recruitment of sufficient new doctors to take their place, one can not help but fear for the future of general practice and with it the future of the NHS as a whole.
And also like Leach who, whilst out on tour in New Zealand just months after his heroics with Ben Stokes, feared for his life when he was hospitalised with sepsis, General Practice too is critically unwell and faces, as has already been said, an uncertain future. With patient demand increasing and the number of both GPs and community nurses in decline, medical centres up and down the country have been forced to close since staff shortages make it impossible for them to remain open safely. 89% of GPs now believe they have inadequate time with patients to provide a thorough diagnosis, 77% of GPs feel that staff shortages are putting patients at risk and, in some parts of the country 82% of GPs say that their practices are not always safe for patients. And all of this is simply because of the immense pressure under which general practice is currently ailing.
Furthermore with the country’s population having been steadily increasing such that it now stands, as was announced this week, at a record breaking 59,597,300 in England and Wales, a 6.3% increase since the census of 2011, it’s little wonder that, like Jack Leach who recently suffered concussion after sustaining a blow to the head whilst fielding, GPs are feeling punch drunk too.
But despite all this General Practice is currently delivering care at levels never seen before with figures proving that it is GP capacity that is the problem and not GP access. According to NHS Digital workforce data, general practice is at present managing an eye watering 1 million appointments a day. This is more than a million more consultations per month than was the case in 2019 and includes an additional 980,000 same day appointments over the last three years. Furthermore, General Practice sees more people every day than the rest of the NHS put together despite the fact that it receives just 5% of total NHS funding.
So whilst they may not be part of the most glamorous aspect of modern medicine, and though they may not be integral to the most eye catching parts of the NHS, those who work in primary care are, irrespective of whether they be doctors, nurses, or HCAs, practice managers, administrative staff or one of the countless other supporting members of the general practice workforce, nonetheless, together putting in an exceptional team performance.
So it’s not only Jack Leach who can feel justly pleased with his efforts. And neither is it only he who deserves a medal!
Because, contrary to what you may have heard, general practice is playing a blinder too!
Related blogs:
To read ‘For when we can’t see why’, click here
To read ‘Jeepy Leepy and the NHS’, click here
To read ‘Bagpuss and the NHS’, click here
To read ‘On Being Overwhelmed’ click here
To read ‘On keeping what we dare not lose’, click here
To read ‘The Repair Shop’, click here
To read ‘The State Of Disrepair Shop’, click here
To read ‘The NHS – the “S’” is for “Service”, not “Slave”’, click here
To read ‘On being crazy busy – a ticklish problem’, click here
To read ‘Too busy to be happy’, click here
To read ‘The Abolition of General Practice’, click here
To read ‘WWJD – What would Jack Do?’, click here
To read ‘Longing for the pavilion whilst enjoying a good innings’, click here
To read ‘Somerset CCC – Good for the soul’, click here
And for a bit of nonsense to read ‘Eve of the RLIDC limericks’ click here!
Some musings 
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