HEALTH bosses in Dorset have outlined radical measures to reduce the burden on GPs in a system ‘on the brink of collapse.’

The director of a new workforce centre set up last year to cope with a critical shortage of doctors in Dorset has warned that traditional family surgeries are ‘unsustainable.’

Instead, the Daily Echo can today reveal patients can expect to see multi-disciplinary teams operating across larger areas where receptionists are even trained specifically to divert time-wasting patients, who are to blame for a quarter of unnecessary consultations.

As previously reported, GP mergers are already taking place in the county and some practices have been forced to close their doors as doctors battle to meet a rising demand for appointments amid a recruitment crisis.

Steve Aylwin, senior workforce lead of the Primary Care Workforce Centre set up by NHS Dorset Clinical Commissioning Group, Bournemouth University and Health Education England (Wessex) said 90 per cent of GPs who are finishing training in Dorset have worryingly told how they plan to leave the county as soon as they qualify to find a job elsewhere - including in Australia and New Zealand.

He said: “General practice is a very difficult place at the moment. There is high demand and that demand is increasing. Everyone is working long hours. You very rarely meet a GP who works less than a 12 hour day.

“The traditional smaller model of having a small practice serving a small population is not sustainable in terms of use of workforce and patient care.

“With the larger models you can potentially provide better quality care through a multi-disciplinary team.

“However no change is not an option.

“We want to retain our GPs. We want to stop them from leaving practice because they are disillusioned from it or they don’t feel they can keep up with the demand. If we can take away some of the things that may be having a negative impact on GPs and how they may be feeling about the job, then even better.”

Examples of measures coming to Dorset include ‘workflow optimisation’ by the end of summer where receptionists will be trained to manage clinical admin work so GPs are released to spend a great proportion of their time with patients. The move will mean up to 80 per cent of patient correspondence is completed without the GP, freeing up about 40 minutes of GP time each day, the Workforce Centre said.

Receptionists across Dorset will be given training to become ‘care navigators’ next year.

Steve explained they will sit at reception or in waiting rooms to find out patients’ reasons for wanting a GP appointment and will then direct them to more appropriate services if suitable.

In a pilot, out of 6,366 patients asking to see a GP, just 26 were referred to a GP and an estimated 930 GP hours were saved across six practices.

Practices are being urged to better use talents in the wider workforce. This includes employing clinical pharmacists in surgeries, who can deal with minor ailments, medicine issues and help people with long term conditions, employing advanced nurse practitioners, physiotherapists and even paramedics to alleviate the burden on GPs.

Dorset GPs are already employing musculoskeletal practitioners to their workload because according to the Workforce Centre, research has revealed between 30 per cent and 40 per cent of a GP’s workload is dealing with muscular skeletal issues which increases to up to 50 per cent of cases in over 75s.

The centre has also revealed plans to launch a new programme next year to train physician associates who could also help plug the workforce gap.

Steve said: “We need to free up GPs to do what GPs should be doing. It’s about not always filling a GP size hole with a GP. The public will see a more multi-disciplinary team and may not see a GP at all if their needs can be met by another professional. It’s not to say GPs aren’t needed, they absolutely are. They won’t be replaced. It’s about the shift patients will see in the services and the way they operate.

“Could GPs start to have a consultant role with a team working underneath them? Maybe. I think there will be different models in different areas but that concept of people working together and sharing services to help reduce cost and help improve efficiencies will be more important.”

Dorset’s STP, which forms part of a package of NHS reforms across the country, proposes ‘integrated teams’ ‘to deliver more and better services from a fewer number of sites.

As revealed in the Daily Echo, ‘super surgeries’ with up to 50,000 patients could be introduced. In a draft report of the Primary Care Commissioning Strategy and Plan, Dorset CCG proposed a new ‘integrated GP mode’ which could see the number of GP surgery sites more than halved in the county from 131 to between just 36 and 69.

In central Bournemouth alone 10 sites, used by seven practices, could be reduced to just three.

Doctors at the British Medical Association’s annual meeting in Bournemouth last week heard that nearly 200 practices shut to patients last year.

Leading medic Dr Chaand Nagpaul said GP services were on the ‘brink of collapse.’

The Primary Care Workforce Centre will host the event Workforce Solutions – Breaking Through Barriers for GPs on Thursday, July 13. For information go to