GP talks rewarding career in Butetown

20 June 2018

Dr Simon Braybrook, GP Partner Butetown Medical Practice, talks about the challenges and rewards of working as a GP in Butetown, Cardiff.

Despite hearing of the challenges, I wanted to work in Butetown Medical Practice, a mid-size 8,000 patient inner city practice, since I was a trainee. Not being successful at interview the first time around, I was not put off by a six month placement as an academic fellow, and joined the partnership 4 years ago.

There really is no practice like it. Dr Kay Saunders founded the practice 20 years ago and, responding to local need, created a unique practice which provided exemplary care to the homeless and vulnerably housed population in Cardiff. The vast majority of the estimated 40-60 street and several hundred hostel homeless in Cardiff register with us. Additionally, we have a broad multi-ethnic population, with 40 plus language groups in a one mile radius, but also very wealthy residents of “new” Cardiff Bay. “From Penthouse to doss-house” is how it has been described!

The work is immensely varied. Every day we deal with methadone, blood-borne viruses, exotic diseases like TB (and even malaria recently), complex mental health problems or severe physical complications of street living like dermatitis neglect and trench foot. Chronic disease management can be extremely difficult. You can only imagine the consequence of street living on insulin dependent diabetes, for instance.

It also means we have had to adapt the way we work. Strict appointment times simply do not work within a population who live chaotic lives or don’t speak English, and so a “sit and wait” open surgery approach is often used.

Like many practices, especially in poorer areas, recruitment of doctors is a major problem, and we have been short of doctors from time. This means we have had to be flexible and have recently appointed two highly trained paramedics to assist with face to face triage and acute care. So far this has been very well received.

Working in a practice like this is extremely tiring and stressful but, even on my very worst days; I can honestly say Id sooner give up practice than work anywhere else. Every day is remarkable. Every day is rewarding.

- Dr Simon Braybrook

Dr Braybrook was recently interviewed for the BBC Wales Programme “The Hour” about his valuable work with the homeless in Cardiff. The programme is availible on BBC iPlayer.