News

GP shortage in Wales: Patients per doctor double European average

Published

10 months ago

February 13, 2025

THE NUMBER of patients per GP in Wales is over twice the European average, raising concerns about primary care availability for hundreds of thousands of patients across the country.

In 2024, a report by BMA Cymru Wales showed that the European average for patients per GP was around 1,000. In Wales, the average is 2,210 patients per full-time GP. Over the last decade, the average number of patients per practice has increased by just under 25%.

RURAL ISSUES

Over the past decade, the number of GP practices in Wales has decreased by 18%, dropping from 470 to 378. This decline is due to a combination of closures and mergers, reflecting broader challenges in general practice, such as workforce shortages and increasing patient demand.

The situation is worsened by the fact that around 80% of Wales’s land area is relatively sparsely populated, consisting of small settlements grouped around former market towns. New GPs are overwhelmingly concentrated in Wales’s few larger urban centres, chiefly along the M4 corridor and the North East Wales border area.

This means rural patients often have to travel significantly longer distances to access GP services compared to urban residents. The closure of rural practices forces patients to register with larger, more distant surgeries, increasing the patient-to-GP ratio. This results in longer waiting times and reduced appointment availability.

Long travel times and a lack of transport deter individuals from seeking timely care, leading to delays in diagnosis and treatment. By the time patients present for clinical care, their conditions may have worsened, making treatment more expensive and reducing the likelihood of positive clinical outcomes.

And that is before patients are placed on one of the NHS’s lengthy waiting lists for diagnosis and treatment.

The older age profile of Wales’s rural GPs was long recognised as a ticking time bomb under primary care. Yet, efforts to stem the outflow of GPs from rural Wales have been patchy and ineffective. Changes to pension rules have accelerated retirements, and as older rural GPs leave the profession, replacing them has become increasingly difficult.

The reasons are clear. Rural Wales faces huge difficulties attracting and retaining GPs due to professional isolation, fewer career development opportunities, and a lack of interest in rural practice partnerships. These factors have led to a reliance on locum doctors or salaried GPs, which in turn can disrupt continuity of care.

IN PEMBROKESHIRE

Practice closures and the shortage of GPs have hit Pembrokeshire hard.

The Argyle Medical Group in Pembroke Dock is the second-largest GP practice in Wales, with around 25,000 patients registered and just nine GPs—an average of 2,800 patients per GP. In 2021, the practice had 10.75 full-time equivalent GPs and was seeking to recruit more. However, due to a lack of available GPs, the practice was forced to withdraw from its Neyland practice at St Clement’s Surgery and reduce hours at St Oswald’s Surgery in Pembroke.

**Argyle Medical in Pembroke Dock has the second-largest GP practice in Wales**

As a knock-on effect of the Neyland closure, patients were transferred to the Neyland and Johnston Medical Practice, which eventually handed back its GP contract following retirements and recruitment difficulties. Its patients are now serviced by salaried and locum GPs employed by the Health Board.

The same issues have plagued GP practices from Tenby in Pembrokeshire’s southeast to St Davids in the northwest. While it would be a stretch to say that “GP deserts” exist in the same way as “NHS dental deserts,” the increasing patient load on hospitals suggests that many people are now seeking treatment at A&E for conditions that would previously have been managed by a GP.

The Welsh Government’s approach is to ask patients to self-triage before going to hospital—an impractical and, for many, heartless solution. If you are a parent with a child in agony and unable to tell you what is wrong, what would you do?

SITUATION NORMAL, SITUATION CRITICAL

In 2018, the Welsh Government announced a plan to recruit 1,000 GPs into NHS general practice in Wales. While the number of GPs has increased, it has not risen by anything close to 1,000. Worse still, the number of full-time GPs has actually fallen.

What this means is that while there are technically more GPs in total, there are fewer available in practice because many of the new recruits work part-time, as locums, or on limited contracts (for example, as doctors on call).

It’s the same statistical sleight of hand used to describe frontline clinical staff in the Welsh NHS. Welsh Government ministers proudly claim that the Welsh NHS employs more people than ever, yet the number of full-time staff has plummeted.

In an attempt to address the GP shortage, the Welsh Government has increased the number of routine clinical assessments and treatments that pharmacists and practice nurses can undertake. However, only seven relatively minor ailments can be treated by pharmacists independently, while practice nurses must have GP approval to prescribe medication.

Expanding community-based healthcare is a sensible aim, but it is undermined by the critical shortage of full-time GPs in rural Wales. There are not enough independent prescribing pharmacists or community nurses to fill the gap. The reliance on locum GPs disrupts continuity of care, leading to situations where patients are taken off long-term medication without explanation or, worse, experiencing increased risks of missed or misdiagnosed conditions.

Wales has reached a tipping point.

Politicians frequently offer warm words about “our NHS,” “our precious NHS,” and “our wonderful NHS nurses and doctors,” but none have publicly acknowledged that the foundation of NHS care—GP surgeries as the first point of contact for the sick—has buckled. If they did, they would have to come up with real solutions instead of blaming patients for being ill or making vague promises about digital medicine transforming rural healthcare.

The situation is critical.

In Wales, that passes for normal..

Community

Craig Flannery appointed as new Chief Fire Officer

Published

15 minutes ago

December 19, 2025

Tom Sinclair

MID AND WEST WALES FIRE SERVICE LEADERSHIP CHANGE

MID and West Wales Fire and Rescue Service has announced the appointment of Craig Flannery as its new Chief Fire Officer, with effect from Monday, December 15, 2025.

Mr Flannery has served with the Service for more than twenty years, progressing through a wide range of middle management and senior leadership roles across both operational and non-operational departments.

During his career, he has been closely involved in strengthening operational delivery, risk management and organisational development. His work has included leading innovation in learning and development, overseeing the Service’s On-Call Improvement Programme, and driving investment in key enabling functions such as workforce development and information and communication technology.

The appointment followed a rigorous, multi-stage recruitment process led by Mid and West Wales Fire and Rescue Authority. Candidates were assessed through structured interviews, strategic leadership exercises and scenario-based assessments designed to test operational judgement, organisational vision and the ability to lead a modern fire and rescue service.

External professional assessors were also engaged to provide independent scrutiny, ensuring the process met high standards of fairness, transparency and challenge.

Mr Flannery emerged as the strongest candidate, demonstrating clear strategic leadership capability, detailed organisational knowledge and a strong commitment to community safety and service improvement.

Councillor John Davies, Chair of Mid and West Wales Fire and Rescue Authority, said: “Craig brings a deep understanding of our Service and a clear vision for its future. His appointment will strengthen our ability to innovate, support our workforce and deliver high-quality protection for the communities we serve.

“As we navigate a rapidly changing landscape, Craig’s experience in driving innovation and organisational development will be invaluable in helping us adapt and transform for the future.”

Commenting on his appointment, Mr Flannery said: “It is a privilege to lead this outstanding Service. I am committed to supporting our people, strengthening partnerships and building on the strong foundations already in place.

“As the challenges facing fire and rescue services continue to evolve, we must modernise and innovate, ensuring we have the skills, technology and capability needed to meet the needs of our communities. I look forward to working with colleagues and partners across Mid and West Wales to deliver a resilient, progressive Service that keeps people safe and places our staff at the heart of everything we do.”

Health

Resident doctors in Wales vote to accept new contract

Published

6 hours ago

December 18, 2025

Tom Sinclair

RESIDENT doctors across Wales have voted to accept a new contract, with 83% of those who took part in a referendum backing the agreement, according to BMA Cymru Wales.

The contract includes a four per cent additional investment in the resident doctor workforce and introduces a range of reforms aimed at improving training conditions, wellbeing and long-term workforce sustainability within NHS Wales. The BMA says the deal also supports progress towards pay restoration, which remains a central issue for doctors.

Key changes include new safeguards to limit the most fatiguing working patterns, measures intended to address medical unemployment and career progression concerns, and reforms to study budgets and study leave to improve access to training opportunities.

Negotiations between the BMA’s Welsh Resident Doctors Committee, NHS Wales Employers and the Welsh Government concluded earlier this year. Following a consultation period, a referendum of resident doctors and final-year medical students in Wales was held, resulting in a clear majority in favour of the proposals.

Welsh Resident Doctors Committee chair Dr Oba Babs Osibodu said the agreement marked a significant step forward for doctors working in Wales.

He said: “We’re proud to have negotiated this contract, which offers our colleagues and the future generation of doctors safer terms of service, fairer pay, and better prospects so that they can grow and develop their careers in Wales.

“This contract will help to retain the doctors already in training, and also attract more doctors to work in Wales, where they can offer their expertise and benefit patients.”

Dr Osibodu added that the BMA remains committed to achieving full pay restoration and acknowledged that challenges remain for some doctors.

“Whilst this contract sets the foundations for a brighter future for resident doctors in Wales, we recognise that there are still doctors who are struggling to develop their careers and secure permanent work,” he said. “We need to work with the Welsh Government and NHS employers to address training bottlenecks and underemployment.”

The Welsh Government has previously said it recognises the pressures facing resident doctors and the importance of improving recruitment and retention across NHS Wales, while also highlighting the need to balance pay agreements with wider NHS funding pressures and patient demand.

The new contract is expected to be phased in from August 2026. It will initially apply to doctors in foundation programmes, those in specialty training with unbanded rotas, and new starters, before being rolled out to all resident doctors across Wales.

Crime

Swansea man jailed for online child sex offence dies in prison

Published

6 hours ago

December 18, 2025

Tom Sinclair

A SWANSEA man who was jailed earlier this year for attempting to engage in sexual communication with a child has died while in custody.

Gareth Davies, aged 59, of the Maritime Quarter, was serving an 18-month prison sentence after being convicted in May of sending sexually explicit messages to what he believed was a 14-year-old girl. The account was in fact a decoy used as part of an online safeguarding operation.

The court heard that Davies began communicating with the decoy between November and December 2024 and persistently pursued the individual, later attempting to arrange a face-to-face meeting. He was arrested after being confronted by the decoy operators.

Davies had pleaded not guilty but was convicted following a trial. At the time of sentencing, police described the messages as extremely concerning and said his imprisonment was necessary to protect children.

It has now been confirmed that Davies died at HMP Parc on Wednesday (Nov 27) while serving his sentence.

The Prisons and Probation Ombudsman has launched an independent investigation into the death, which is standard procedure in all cases where someone dies in custody. No cause of death has been released at this stage.

A coroner will determine the circumstances in due course.