General practice (GP)

Nature of the work

General practitioners have an important role in looking after patients in their homes and within the communities where they live. They are part of a much wider team whose role includes promoting, preventing and initiating treatment. GPs look after patients with chronic illness, with the aim to keep people in their own homes and ensuring they are as well as they possibly can be.

GPs are often the first point of contact for anyone with a physical or mental health problem and patients can be at their most anxious. Looking after the whole person - the physical, emotional, social, spiritual, cultural and economic aspects through patient-centred approaches is a vital part of any GP’s role. This is becoming more important with terminally ill patients often choosing to stay at home.

There are over 1.3 million GP consultations every day, most of which take place in a GP surgery or within the patient’s home. GPs occasionally work as part of teams attached to hospitals with roles in accident and emergency centres, discharge planning and in unscheduled care (such as urgent care centres). In the community they may run clinics in schools and in residential and nursing care homes.

A typical GP appointment is scheduled to last for ten minutes, during which time the GP needs to assess the patient. As anything can come through the door, they make swift and effective decisions based on the presenting symptoms, and the patient’s current and previous medical history. They also use their own knowledge to assess the likelihood of a certain illness being present over another. GPs look for patterns of symptoms to indicate or rule out different conditions. Up to 40 % of a doctors consulting can now be done over the telephone, rather than in face to face encounters and the shift to using different media is likely to expand in the future.

Depending on their examination and diagnosis the GP has several management options which they will discuss with the patient as they develop a shared and agreed plan. These can include giving reassurance, giving the patient information, advising on a certain course of action or prescribing medication. Alternatively they may refer the patient for further tests to confirm a diagnosis or as part of an on-going management plan. These can include x-rays, blood tests or referring on for a second opinion. They are trained to spot the signs of “red flag” symptoms, which might indicate a serious problem requiring further investigation and which needs to be acted on promptly.

Patients may occasionally attend the GP surgery with an urgent life-threatening condition, such as anaphylaxis (severe allergic reaction) or an asthma attack. In these cases the GP will provide life-saving treatment until an ambulance and further help arrives.

GPs work as part of large multidisciplinary teams (MDTs) who all support the holistic [1] care of any patient and these can include nurses, midwives, health visitors, pharmacists, physician associates, psychiatrists and care of the elderly specialists. They meet regularly to discuss cases and plan joint approaches to co-ordinate packages of care.

 Another important part of the work is preventative medicine and health promotion. This can include clinics for child immunisations and smoking cessation as well as advice on lifestyle during the GP consultation. GPs also have a vital role to play in safeguarding vulnerable children and adults, and involving appropriate agencies.

GPs see patients of all ages from newborn babies to elderly people. The ongoing relationship that GPs are able to establish with their patients and being able to offer continuity of care is one of the most important and enjoyable aspects of the job. Patients are often quite knowledgeable about their own conditions and GPs will work with them together to decide on a mutually acceptable plan.

GPs have an important role to play in the management of not just of acute problems but also of chronic diseases and the treatment of patients with multiple health conditions, particularly in an ever increasing older population. Balancing and treating multiple problems with a patient’s general health, independence and social care can be complex and challenging, but also rewarding as a GP will know these patients very well.

GPs play a significant role in cardiovascular [2], metabolic [3] and respiratory [4] diseases and mental health problems. They may run clinics at the surgery for patients with chronic conditions such as asthma, hypertension [5] and diabetes.

“It’s really satisfying to be able to successfully treat patients in the community and in their own homes when possible” Catherine Brown is a trainee GP based in Lerwick, the Shetland Islands’ main town.

Read Catherine’s story [6]

Common procedures/interventions

• performing clinical examinations of patients to assess, diagnose and monitor a patient’s condition – these are wide-ranging and may involve the use of specialist equipment such as a stethoscope or otoscope (an instrument for examining the ear)
• carrying out tests within the surgery such as urine sample testing to assist with diagnosis
• interpreting findings from investigations such as blood tests to help reach a diagnosis
• using basic life support skills and emergency procedures such as defibrillation where necessary

What else do GPs do?

The work can vary depending on whether you are a GP partner or a salaried GP.

Salaried GPs:

• are employed by the practice and receive a set salary on a scale according to your experience
• receive all the benefits of being employed, such as sick-pay, holiday and maternity pay
• are mostly involved with clinical work
• have less say in the way a practice is run
• can change jobs fairly easily

GP Partners:

• are self employed and are effectively running a small business
• receive a share of the profits of the practice –  with the potential for higher earnings
• pay their own tax and do not receive benefits such as sick-pay, holiday and maternity pay
• are still involved with clinical work, but also share responsibility with the other partners for decision-making and the ultimate survival of the practice. This includes the financial aspects of keeping the business afloat and employing staff whilst ensuring the practice provides high quality care
• are generally committed to one practice for many years, which offers great continuity for both doctors and patients
• can influence the future direction of the practice and the range of services offered, for example deciding on the staff mix within the practice which can include employing nurse practitioners, paramedics or pharmacists to improve the running of the multidisciplinary team (MDT) and subsequent patient care
• are responsible for the financial success of their practice, even though some GP practices employ a business manager, Business functions such as financial management, practice strategy and policy, service development and recruitment are all part of the job.

Whether you are a salaried GP or a partner, administration is a big part of the work. This includes reading and acting on letters received from hospital specialists and patients, signing repeat prescriptions, death certificates, statements of fitness for work and preparing letters and reports. GPs also carry out audits to improve systems and outcomes of care as part of the Quality and Outcomes (QOF) targets system. Regular staff meetings are also part of life in general practice.

There are lots of other opportunities to develop your role in general practice and embrace special interests. See the section “Where the role can lead” for more information.

Want to learn more?

Find out more about:

• the working life [7] of someone in GP
• the entry requirements [8] and training and development [9]
• three first-hand accounts of life:
  • as a specialty trainee year 3 (GPST3) doctor in general practice [10]
  • as a trainee GP based in Lerwick, the Shetland Islands’ main town [6]
  • as a GP registrar [11]
  • as a salaried GP [12]
  • as a GP partner [13]

​And visit the Royal College of General Practitioners website [14] for information about the Think GP campaign.

• Live vacancies

  • General Practitioner GP

    ESSEX, RM5 3QL

    Salary:

    £10000.00 to £10500.00 a session

    Type:

    Permanent

    Employer:

    Central Advertising - General Practitioners

    Apply now on NHS Jobs for General Practitioner GP job (opens in a new window) [15]

  • General Practitioner - GP

    Halifax, HX1 2HB

    Salary:

    Depending on experience Dependant upon experience

    Type:

    Permanent

    Employer:

    Central Advertising - General Practitioners

    Apply now on NHS Jobs for General Practitioner - GP job (opens in a new window) [16]

  • General Practitioner - GP

    Halifax, HX3 9DG

    Salary:

    Depending on experience Dependant upon experience

    Type:

    Permanent

    Employer:

    Central Advertising - General Practitioners

    Apply now on NHS Jobs for General Practitioner - GP job (opens in a new window) [16]

  • Salaried GP / GP Partner

    Kirkby Stephen, CA17 4RB

    Salary:

    £10000.00 to £11000.00 a session

    Type:

    Permanent

    Employer:

    Central Advertising - General Practitioners

    Apply now on NHS Jobs for Salaried GP / GP Partner job (opens in a new window) [17]

  • Salaried GP

    Bradford, BD11 2HX

    Salary:

    Depending on experience £11k per session negotiable

    Type:

    Permanent

    Employer:

    Central Advertising - General Practitioners

    Apply now on NHS Jobs for Salaried GP job (opens in a new window) [18]

  • Salaried GP

    Batley, WF17 5QT

    Salary:

    Depending on experience £11k per session negotiable

    Type:

    Permanent

    Employer:

    Central Advertising - General Practitioners

    Apply now on NHS Jobs for Salaried GP job (opens in a new window) [18]