In her final speech as Welsh GPC chair, Dr Charlotte Jones said it was a 'credit to the strength of the profession in Wales' that practices had maintained 86% satisfaction among patients during 'turbulent years'.

Speaking at the annual conference of Welsh LMCs, she hit out at 'workforce shortages, underinvestment in GMS and increasing workload pressures', warning that levels of stress and burnout among GPs were higher than ever before.

Dr Jones told the conference: 'It is a sad fact that the daily grind of working in general practice is not enabling us to do the job we love and trained for as we are spending all our time firefighting and just getting through the day. This is neither sustainable nor acceptable.'

Practice closures

The Welsh GPC chair said growing numbers of GP practices were finding it impossible to carry on. 'All too many practices cannot see any other option but to hand back their keys to the health board with at least 21 practices having handed back their contract, 29 practices being health board-managed, 37 practices having submitted sustainability support applications to the health board and a further 45 practices deemed at risk.'

She said that 50,000 patients had seen their practice close, and 310,000 more - around one in 10 people in Wales - were registered at practices at risk of closing.

'These figures, coupled with the increasing strain being experienced by practices shows the sheer crisis within the profession,' Dr Jones warned.

The experience of health boards running GP practices that had closed proved that the independent contractor model was far and away the best option, Dr Jones told LMC leaders.

Funding

She cited examples in which health boards had been forced to spend between £300,000 and more than £500,000 over and above the standard GMS allocation to keep in operation practices that they had taken direct control of.

'Just imagine what we could do with just a fraction of that additional resource,' Dr Jones said.

Pointing to some factors 'going in the right direction', Dr Jones listed a sickness and maternity agreement, plans for state-backed GP indemnity and in particular the Welsh government's acceptance in full of the 4% pay award recommended by the Doctors and Dentists Review Body - a rise rejected in England.

She called for a series of steps to improve the outlook for practices in Wales, including a 'comprehensive indemnity agreement', measures to attract and retain staff, and a scheme to support GPs facing significant financial risk as 'last partner standing'.

Dr Jones also called for more support for GP 'clusters' in Wales - including funding to help them pump prime service changes, greater autonomy and work to spread best practice.