Dr Simon Abrams

GP lead Liverpool

I am a GP and proud to be one. It is just over 20 years since I started. My practice is in a deprived part of Liverpool and has a list of 2500 patients. It’s a training practice with a GP Trainee, an FY2 and medical students.

I was a hospital doctor for nine years before moving to general practice. I realised that the parts of medicine I most enjoyed were the interactions with patients. To me they seem the most honest and rewarding and that’s still the part I most value and enjoy.

Working in general practice, I have learnt many new skills including much more sophisticated consultation techniques and how to provide care to populations as well as individual patients.

As a hospital doctor I started speciality training in cardiology and paediatric cardiology so when I arrived in GP land there was an expectation that I continue. I chose a medical centre in a deprived part of the city with the hope of making a difference.

I soon discovered that our patients had bigger problems with drug and alcohol addiction. These were the daily issues that came through my door. I was able to participate in conferences and seminars on drug and alcohol misuse and took further training as a GP with special interest in drug misuse. The practice specialises in these services for vulnerable patients. There is a shared care drug misuse clinic which involves working closely with the local drug and alcohol misuse service. In addition, the practice holds the Zero Tolerance contract for Liverpool, taking patients for 12 months who have been removed from other GP lists for disruptive behaviour. Curiously, they are usually no trouble at all.

With many patients having their health affected by low income and the prevalence of drug and alcohol problems, health care becomes a huge challenge. I am proud that CQC recently assessed our care of vulnerable patients, as outstanding.

The practice’s reputation for effectively managing vulnerable patients has given us confidence to further develop services. At one point we were one of the largest GP providers for asylum seekers. It is not without its challenges but as recently as a year ago we asked staff whether they wanted to keep the Zero Tolerance contract and they immediately agreed to continue - we all find it rewarding. 

We have learnt that when you deal with patients with respect, interest and attention to their health problems, 99% of the time you get the same respect back.

What advice can I offer a medical student or young doctor considering their future career? General practice is a great job. It is very different to hospital medicine – you deal much more with people. Don’t take the word of your hospital colleagues who only get a keyhole view of what it’s really like, go and see for yourself and talk with GPs.