New Milton doctor retires after prescribing GPs' future for the NHS
A LEADING New Forest doctor is standing down from his GP role after producing a high profile government report that could shape the future of general practice.
Dr Nigel Watson will depart the Arnewood Practice in New Milton at the end of this month having worked at the surgery for just over 30 years.
However, he will oversee its potential merger with other local surgeries and is remaining as the chief executive of the Wessex Local Medical Committees Ltd (WLMC), which represents GPs who work across the south of England.
In an exclusive interview with the A&T, Dr Watson, who is an MBE, said he had made his decision because he could not devote enough time to his GP role.
“Having spent some time with lots of different roles I recognise it’s increasingly difficult to keep up to date and to speed and the time had come to make the decision to hang up the stethoscope essentially,” Dr Watson said.
“It was a hard decision to make but I can’t do everything,” he continued. “All of the roles are expanding and taking up most of my potential free time. The last thing I would want to do is become a bad doctor or a danger doctor because I was not up to scratch.”
During the early part of 2018 Dr Watson was a GP for two days a week and WLMC chief executive for the other three days at Chandler’s Ford.
But he took a sabbatical from his GP role in May last year after being appointed by Conservative then Health Secretary Jeremy Hunt to lead a report on the future of general practices, which was published on Tuesday.
He was approached after it was revealed the number of GPs in practice had fallen by 2,000 in the last two years. The government has a stated aspiration of wanting 5,000 more GPs by 2020.
Dr Watson’s report – called the GP Partnership Review – was tasked with investigating the problems GPs face and how general practices partnering up with other services could help ease the workload and workforce burdens placed on GPs and help attract more people to the profession.
He had the support of leading health agencies, including NHS England, General Practitioners Committee, the British Medical Association and the Royal College of GPs.
While researching the review he also toured the UK, visiting places from Devon to Kent, Nottingham to Liverpool, Newcastle, and Bristol to speak to GPs, health professionals and patients.
Shortly after his appointment Mr Hunt was replaced in a government reshuffle by Matthew Hancock, but Dr Watson said it did not affect his work at all.
Dr Watson’s review concluded that the current model of NHS care is “too dependent on hospital-based care”, was “not sustainable” and could not move forward without change that includes general practice and partnerships at its heart.
It has made seven overall recommendations, including more GP funding, a refocus of medical training and the establishment of Primary Care Networks to ensure practices were sustainable and could address workload and safe working capacity while continuing to support quality care.
The review also said opportunities should be taken in technology to ensure practices were efficient and had access to innovative equipment and in legal terms to reduce the personal risk and unlimited liability currently associated with GP partnerships.
“Without general practice the health of our population will worsen, access to specialist care will become more difficult and the cost of providing health care will increase significantly,” it said.
“This is what we already risk in some parts of the country. With an ageing population and increases in the number of patients with long term conditions, the future looks bleak for general practice unless action is taken now.”
The review warned: “Doing nothing cannot be an option. The consequences would be clear – the widening of health inequalities, with areas of the country where general practice will struggle to continue, the inevitable rise in pressure and costs in the rest of the health and care system, worsening clinical outcomes, and falling patient trust in the NHS.”
Dr Watson told the A&T his review found GPs greatest concerns were “workload, workforce and risk”.
Previously GPs started work at 8am and were home by 6.30pm, having seen 20 patients, and gone through their correspondence and blood tests and completed home visits, he said.
But now GPs worked from before 7am until past 8pm at night, their patients had more intensive and complex needs and the paperwork they did was a lot more substantive.
“The workload for everyone has just expanded, plus it’s much more intensive and much more complex,” Dr Watson said. “Of course there’s also a chance of more mistakes happening.”
He recalled when he started as a GP at New Milton there were 170 applicants for the job, but some surgeries were now having trouble recruiting GPs at all just to get to sufficient staff levels.
Surgeries were part of the NHS but effectively “independent contractors” he pointed out, and had to pay staff, doctors and the bills, and the financial risks were off-putting for younger doctors, he said, as were the long hours.
“The NHS is still one of the most trusted institutions and it’s really important we deliver high quality care to our community.”
Reflecting on his time as GP, the Dr Watson (59) said the biggest change at New Milton was the size of the practice, the workload the doctors faced and the nature of ailments they treated.
When he started there were four doctors and some nurses covering 10,000 local people, he said, and medical problems such as diabetes were managed by hospitals.
“Now we can do so much more for people and stop them dying of heart disease or help them survive cancer but as a consequence with GPs the workload has expanded hugely.”
He said he would miss being at the New Milton practice, where his wife, Jane McLeod, also works part-time as a GP. The pair have a son, Mark, who is a barrister.
“I was in there this week for the partner meeting and I have to say it’s been quite difficult – it exerts a pull being a part of it and having been there all my working life I know it’s a special place.
“It has really been like a second family going all the way back to when I started. Some of your readers will remember Drs Ball, Hewish and Thacker, who I’m still in contact with, and back when I joined I developed hugely because of those and other people based there and I hope I made a contribution to the practice as they did.”
Addressing the potential merger of the New Milton practices, Dr Watson said he was a big advocate. “One of my regrets is that I’m not 10 years younger as it would be really exciting with the practices looking to work more collaboratively and merge to create a single practice,” he said.
“It is all about building more services for our local population in our community. The good news is not just for our residents but it will also make general practices more resilient and sustainable in the future,” Dr Watson said, adding: “This is definitely the right way forward”.
He pointed out the government has set aside £4.5bn to invest in community and primary care. “The merger would put us in a great place to benefit from the resources that will be coming,” he added.
In a final message to patients, Dr Watson said: “I have really enjoyed working in the practice in New Milton and I have met many amazing people. It’s been a real privilege and honour working with the patients I have got to know and who have let me into their lives.
“I’m going to miss them but although I have left I know I leave behind what is a great practice with the greatest doctors and staff who are really dedicated to providing care to the residents of New Milton.”