Dr Gemma Atwell
GP and Clinical Teaching Fellow, Bradford
I work as a GP in a post-industrial city centre in Northern England. At our practice we care for an exceedingly diverse population of patients. I feel very fortunate to love my work, it work gives me an incredible insight into the reality of life for patients with such different stories and backgrounds. With this insight comes the responsibility and privilege of being able to make a difference, no matter how small to our patients’ lives.
There are two sessions that I find especially rewarding, one is the weekly drop-in for patients who are homeless or in unstable accommodation and the other is the late night surgery for women who are involved in prostitution. I try to ensure that through these regular, easily accessible surgeries, I have the time to build trust, show kindness and identify the patients’ frequently complex underlying problems.
There often seems to be a significant gap between identifying the problems and being able to change them, but being available for the patients to drop-in each week allows the continuity to slowly chip away at the issues. I don’t expect big changes, although they do occasionally happen. One of our current staff members is testament to that. Three years ago she was unemployed, living in a tent and cachectic. With support from a wide team she has made an incredible recovery to being housed, employed and most importantly happy. Stories such as this are wonderful to be a part of but they are unusual. Mostly we celebrate small improvements and are more concerned with travelling in the right direction with our patients. If a leg ulcer is improving, if someone gains more stability after starting methadone or if someone who I’ve seen on five previous occasions about their depression smiles for the first time.
As with wider general practice, both of these surgeries are a team effort. I work alongside a fantastic mental health nurse and practice nurses and we work closely with support workers and housing workers. I think I would feel as though I was drowning if I did these surgeries alone, but as a team we can help and support each other, each giving our individual expertise. A patient turning up at one of these surgeries will often be swept between us all, having wounds cleaned and dressed, physical and mental health needs assessed and plans put in action, housing plans initiated, sometimes with breaks for tea and toast in our wellbeing centre providing a breather for the patient. The plans may come to nothing or they might make a positive change, either way we are pleased to be able to be there the next week and the one after and the one after to try and help again.