With medical staff bracing themselves for a challenging autumn and winter, Dr Stefan Waldendorf has reached out to frustrated patients looking for appointments, and urged them to be tolerant, particularly of staff, who have, at times, faced abuse.
Dr Waldendorf, who works at Linden Hall Surgery in Newport, says efforts are being made to ease the 'dire situation' which GPs have found themselves in as a result of mounting pressures.
And he hopes schemes such as the introduction of new 'workforce members' can help to improve things and reassure the public that more services are available and being provided.
The duty doctor at Linden Hall, which has a patient participation group for raising issues that arise, currently has to deal with up to 50 telephone appointments every morning, having had numbers of 15 to 20 before the pandemic.
Dr Waldendorf said such a rise in patient demand had been a challenge and, with winter coming, further difficulties could lie ahead.
"GPs are under an unprecedented workload pressure, far more than I have seen in my 20-year history as a partner here," he said.
"Doctors are under constant unsustainable time constraints and there is immense pressure on us to provide more and more appointments.
"Usually the summer is a quieter time, with people on holiday and not getting ill as much, so you tend to get some breathing space - but that hasn't happened this year and people are dreading the autumn. Coughs, colds or a flu outbreak – it could explode.
"So I really want to communicate with patients, both to reassure them and give some understanding of the situation."
Dr Waldendorf added: "Patients who struggle to get an appointment are getting increasingly frustrated and we have seen receptionists experience increasing amounts of abuse and pressure from the public. This, on its own, leads to high turnover of staff and difficulty to recruit new ones.
"A message I am really keen to get out is that I understand people get frustrated and, if you feel unwell, you don't want to be told you'll be seen in three weeks' time.
"We are trying our very best to help and look after our patients but there are limits and constant pressure and stress can bring members of the team to their limits.
"We are not standing still though. There are steps we are taking now to make sure, going forward, in a difficult winter, we are prepared."
Dr Waldendorf said GPs were working hard to provide an accessible and prompt service for everyone who needs it.
Several new staff have been added to his practice, including clinical pharmacists, who can review and advise on medication and discuss health problems such as sore throats and water infections.
Social prescribers have been brought in, who can talk patients through issues and signpost them to the best help available.
Primary care paramedics are also on hand to deal with minor health problems and do home visits, and first contact physiotherapists are available to assess issues such as muscular or joint pain.
Dr Waldendorf admitted pressures on GP surgeries and patient demand had been sizeable since the start of the pandemic.
"Patient demand has certainly risen since Covid," he explained.
"The pandemic has left many with increased health anxiety. Symptoms that the public would not have bothered a doctor with in the past are causing concerns and patients need reassurance.
"This is particularly the case for those with respiratory symptoms such as coughs and colds.
"And, of course, lockdown with all its implications – such as isolation, furlough, being out of work – has caused considerable increase in mental health issues like anxiety and depression. We also see this in many younger patients who are struggling to find their way back into education.
"And then there are more patients who are severely ill. There are elderly patients who did not come to their doctor during Covid and are now faced with more complex problems.
"Heart failure, kidney disease and cancer symptoms have developed and got worse over the pandemic and need to be addressed urgently."
That demand for GPs has been exacerbated by 'dysfunctional secondary care' – the hospital outpatient system - which has had a knock-on effect on GP surgeries.
"Patients are waiting for hospital appointments for many months and sometimes years," added Dr Waldendorf.
"I had one patient who was happy to get an appointment in August after I referred him to urology in June – until he realised it was for August 2024.
"The knock-on effect is that patients who would have been seen by a cardiologist, someone in orthopaedics and many other specialities are not being seen.
"And those patients naturally then come back to their GP asking for letters to speed up the process or they require management of the pain or other problems. These patients need to be managed by their GPs on top of everyone else."
That, Dr Waldendorf says, is easier said than done with a nationwide crisis in the NHS, which has left it at 'breaking point' and impacted on GPs.
"There is a decline in GP numbers," he said, "and more doctors than ever work part time. There have been recruitment campaigns to increase the number of GP trainees but this has been with limited success.
"The high stress level has led to many doctors leaving the profession and junior doctors leave just after training to work abroad."
Dr Waldendorf hopes, though, that the addition of new workforce members can help.
"We have primary care networks now, groups of surgeries working together," he said. "Our Newport and Central PCN worked together last year to set up and run the Covid Vaccination Hub.
"Over the last two years, the PCN has employed new professionals to help, such as pharmacists and mental health practitioners, to help with the workload.
"They are having additional training to work in primary care to deal competently with most problems.
"I want patients to know we are still here for them and they will be seen. We still see ourselves as family surgeries and have history with our patients – from six-week checks to helping them in their 20s and beyond.
"Those who call for appointments may be asked a few more questions from receptionists but I'd call on people to please be patient.
"We will try our utmost to find the right, suitable appointment for you as soon as possible and I'd just urge people not to vent their understandable frustration at receptionists and other staff, who have a very tough job trying to help every patient."