AS THE NHS approaches its 70th birthday, Poole GP Nick Evans could be forgiven for feeling more nostalgic than most.

Because he is the son and a grandson of GPs whose service spans the entire length of the NHS from the day it was launched – July 5 1948. And the family was brought up close to the village in Wales where the NHS's iconic founder, Aneurin Bevan, lived.

While some things remain unchanged - the key contents of a GP’s case (stethoscope, blood pressure cuff and reflex hammer); 10 minute consultations and an understanding that good communication with patients is as important as the care they receive, Nick's grandfather, Dr Alun Evans, says others have gone completely.

"Clinics were ‘turn up and wait’ and cases ranged from respiratory problems - a result of coal dust from the mines – to infectious diseases," he says. "Two surgeries a day allowed around 30 patients to be seen and with easy access to the local cottage hospital, problems could be resolved quickly. Those who couldn’t come to the practice would be visited at home, eventually being ticked off from the doctor’s ‘little black book’."

Alun also helped to deliver babies and act as anaesthetist during routine operations which were carried out by his brother. As for out of hours’ care, Alun recalls: “We were on call night and day every day including Sunday. People didn’t have phones so they would come and knock on the door. You’d have to answer in whatever you were wearing – even your dressing gown. I never declined a call and although they were all very nice people, I looked forward to my two weeks holiday each year.”

Fast forward to 1979 when Peter Evans, Nick's dad, joined a practice in Hampshire, having spent a number of years working with his father in Wales and at Guy’s Hospital looking after children with kidney failure.

“Due to the location of the practice we saw people from all walks of life with common problems including chest diseases, childhood asthma and diabetes," he remembers. "People were beginning to get a bit more informed about their health but we still spent a lot of time explaining things, adjusting what you said to suit the person sitting in front of you.”

An appointment system was introduced and the introduction of GP Fund Holding in 1991 saw the launch of an endoscopy clinic, something that was considered ahead of its time.

"Fewer home visits were needed as more people were driving and home phones were more prevalent," he says. "Out of hours there were no more knocks on the door as the partners took it in turns to be available for around 18,000 patients, often calling ahead to the next patient using the home phone of the current one."

Nick Evans, who works as a GP in Parkstone says: “Being a GP is a great life but the volume of work is definitely growing and although we have huge amounts of technology to help us, even a quiet day is exceptionally busy.

"Typically, I have around 60 patient contacts each day who come in with a real variety of problems. On top of this I also action prescription requests and have to complete an increasing amount of paperwork."

He says the NHS of today is: "Vastly different to the NHS of 1948 and I am sure that in 70 years it will look more different still. While most changes have been positive - morphine and bed rest seemed like the best care for a heart attack in the 1940s, not so much now – the system isn’t perfect and I think we need to acknowledge that, accepting ongoing change as part of life.

"I'd like to see less reliance on paperwork and I think it would have been great fun being a GP in grandpa’s day, things were a lot simpler then.”