Exclusive: CCG morale survey reveals GP workload pressures

GPs in east London are discussing how to tackle pressures on general practice after a CCG poll revealed widespread concerns over workload, funding cuts and quality of life.

Save our Surgeries campaigners in East London protest against cuts (Photo: Wilde Fry)
Save our Surgeries campaigners in East London protest against cuts (Photo: Wilde Fry)

In a survey of morale carried out last month by Tower Hamlets CCG, more than 80% of GPs who responded said workload was negatively affecting their professional life. Almost half mentioned targets or bureaucracy as a problem, and over a third mentioned funding. A third also mentioned patient demand or expectations.

Around 12% of GPs in the borough answered the qualitative survey asking them to describe the positives and negatives of the working lives and what could be done to resolve the problems.

Among positive aspects of the job, around 40% mentioned patients, while about a third mentioned working with colleagues in their practice or across the CCG area.

Other problems raised included media portrayal of GPs, the role of NHS England, too much regulation and political interference. Several GPs mentioned the damage to their own health from pressure. Many said the 10-minute appointment was insufficient.

GPs undervalued

One said: ‘Feeling undervalued & blamed for problems. Never worked harder with less support, feel anxious all the time that can’t manage the work.’

Another wrote: ‘See no positives, except what we are sometimes able to do to help patients.’

One added: ‘Too high and unrealistic expectations from everyone including NHS England, patients/public, managers, politicians, CQC, GMC.’

Another GP said: ‘The workload is constantly increasing, in particular administrative work.

‘Too many changes to what we are supposed to be doing, endless goalpost changes eg the admission avoidance stuff, also stupid things like having to inform patients that they have a named doctor when they already know that as we have personal list.’

Another wrote: ‘The main challenge is the unrelenting demand for appointments/clinical contact, we use a doctor first tele-triage system and so it often feels like floodgates are opened.’

Solutions suggested by GPs included new funding, more admin assistants, a new contract and increased funding for self care promotion.

Collaborative work

Other suggested GPs should work more collaboratively. 

Asked what could be done to tackle the problems, some GPs in the borough, which has been at the heart of the Save Our Surgeries campaign against practice closures, called for firm action.

One called on the profession's leadership to ‘make strong representations’ to resist funding cuts.

Another suggested clear definitions of what is not core GP work and support from ‘bouncing’ unfunded work back.

Asked what GPs themselves would be prepared to do to encourage change, one said they would be prepared to ‘withhold non essential services’ such as boycotting appraisals or CQC inspections. ‘Strike?’ suggested another. ‘The system’s cracked. I feel the situation will get worse before there’s any improvement.’ One GP said they would do ‘anything that does not harm patients’.

Other respondents suggested there was little they could do. ‘I am 60 and I don't care any more,' said one. ‘ Am considering early retirement!,' said another.

Results of the survey will be considered by the CCG and Tower Hamlets LMC and have been presented to the Tower Hamlets GP Forum.

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