[quote TheMotherlode]@helpmeeee11 - genuine question, why are GPs busier? It is all covid related, because they’re busy managing the vaccine rollout, or something else?[/quote]
Where do I start. TL:DR The short answer is increased workload falling on less GPs and systematic defunding of the NHS for decades. Not a political thing - Blair was one of the worst for creaming off money to the private sector and of course the Conservatives aren't friends of the NHS. If you want the long answer then read on....
GP funding has fallen year on year in real terms since 2004. In that time the number of times the average patient sees their GP per year has gone up from about 2.5 to 7 - and yes, this takes into account all the people we never see. Some patients have weekly or twice-weekly contact with the practice, for medical or social reasons.
The number of hospital beds has fallen over the last 30 years and all that work has come to primary care, largely unfunded. So, for example, when I trained nearly 20 years ago, most people with type 2 diabetes moved to secondary care once they started on insulin. Now we manage all that ourselves and only refer if the person has end-organ damage. 30 years ago if you had a heart attack, your GP basically tucked you up in bed with some morphine and came back the next day to see if you were still alive. Now we do masses of primary prevention (lipids, blood pressure etc) to reduce heart attacks and for those who do have one we manage very aggressively afterwards. This is of course good that heart attacks and strokes have fallen, but it is all new work.
Mental health in the community is a joke. Psychiatry are underfunded and understaffed so we end up holding very high risk patients, working outside of our area of expertise and outside where we are comfortable because there are just no services.
The general public are hugely demanding. It is no joke that I get calls from people with low back pain for one day who have taken nothing over the counter, with athlete's foot, dry skin, from people who have broken up with their boyfriend (and I mean just sad about the end of a relationship, not actual depression). The lack of the extended family has made a big difference I think. There is a definite lack of personal responsibility.
Mission creep - I so often hear on the radio that GPs are 'ideally placed' to do whatever the soapbox of the speaker is. Again, this work generally comes with no extra resources.
Covid - we had a few weeks of being quiet while people stayed away but then we had to manage shielding, the challenges of seeing people whilst maintaining social distancing in the waiting room, managing staff illness (my practice had both doctors and admin staff seriously ill and several staff lost close family), and then of course along comes the vaccine. The contractual arrangements for the vaccine were designed so that practices would lose money on it and most have. That's money that will have to come out of future services which will mean less GP time. We now need to catch up on all the things that weren't done due to covid and manage all the people who are deteriorating because they aren't getting their hospital care in a timely manner.
The move to secondary care virtual clinics has led to letters like 'I saw Mrs Smith virtually therefore please could the GP listen to her heart, arrange a blood test and ECG and send me the result'. This is yet more unfunded work when in reality secondary care should be saying 'I saw Mrs Smith virtually, I need to listen to her heart so have arranged to see her face to face and I have done forms for an ECG and blood tests'. This was an ongoing issue of secondary care moving unfunded work to primary care and it has got worse. To be fair to the hospitals they are of course also overwhelmed.
GP burnout. I'm one of those evil part time GPs - I have a portfolio career and when I'm not in the surgery I have lots of roles in GP education, appraisal, medical politics and other things. These all have to be done - we need GPs in the background doing these. But I moved to a portfolio career as I was becoming burnt out as a full time GP. Full time GP is basically unsustainable now for the vast majority of people. Days are often 12 hours, so a 'part time' 3 day a week GP might well do over 36 hours which is close to a full time normal working week.
Pressures of admin - we are accountable to the CCG, NHSE and CQC as well as the press, the GMC and various other bodies. The GMC has just been shown to be institutionally racist, great for a governing body. No-one will tell vexatious complainants to go away. One of the partners at my practice spent 8 hours replying to a complaint from a no-win no-fee solicitor, the gist of which was that an elderly man in a nursing home hadn't been seen. She had to document every single interaction with this patient who, it turned out, had been seen 42 times in the last year. The same family then complained to NHSE and we had to reply again. I have no idea if they will come back via another solicitor.
I could go on but you're probably bored already. You need to know that GPs are leaving in droves because of all of the above. From the output of most GP training schemes around half go abroad straight away. We are doing our best in really difficult circumstances.