GP morale in freefall as bureaucracy cuts time with patients

GP morale has collapsed in the past year as rising workload and bureaucracy have reduced time with patients, a BMA poll reveals.

Dr Chaand Nagpaul: bureaucracy damaging GP services
Dr Chaand Nagpaul: bureaucracy damaging GP services

The poll, designed to support GPC negotiators in talks on the 2014/15 GP contract, found GPs are pessimistic about their income prospects in the coming year, critical of QOF changes and believe many enhanced services are pointless.

The findings are a further sign of the deepening crisis in general practice, coming just days after a DH poll found thousands of GPs could quit the NHS in the coming years after stress among GPs rose to a 15-year high.

More than one in ten GPs currently working in England took part in the poll, which found 97% believed ‘bureaucracy and box-ticking’ had increased in the past year.

A total of 94% said they were working harder now than a year ago, and 86% said their morale had fallen over the past year.

QOF targets were highlighted as a key factor in rising bureaucracy, with 82% of GPs reporting that increased workload relating to the framework has reduced access to routine appointments for other patients.

Three quarters (76%) of GPs also said that higher QOF workload had left them with less time for patients’ other clinical needs.

An overwhelming 89% said raising QOF thresholds would not improve patient care – in 2013/14 upper thresholds rose to 97% or more in 11 QOF indicators in England, compared with a previous maximum of 90%.

Rising bureaucracy and workload have also cut the time GPs can spend on commissioning, with 45% reporting these factors meant they were now ‘less engaged with their CCG’.

GPs are pessimistic about their income prospects for the coming year, with 89% believing income will fall and expenses will rise in 2013/14.

Changes to directed enhanced services (DESs) were heavily criticised in the survey.

A total of 64% of GPs said the dementia DES was of little or no benefit to patients, and similar numbers gave the same verdict on DESs for remote care monitoring, risk profiling and extended hours.

Around half of GPs thought the alcohol related risk reduction DES was of little or no benefit to patients, but around half said DESs for learning disabilities health checks and online access were very or quite beneficial.

GPC chairman Dr Chaand Nagpaul said: ‘The results of this survey demonstrate that an increase in bureaucracy, box ticking and administration has damaged GP services and patient care, mirroring a government funded report into GPs’ working lives.

‘GP practices are already struggling with declining funding and rising patient demand, especially from an ageing population. Recent changes to the GP contract have created additional and unnecessary workload that is diverting valuable time away from treating patients.’

Dr Nagpaul added: ‘The BMA wants to work with the government to deliver real benefits to patients and remove the administrative burden that is putting pressure on already overstretched GP services.

‘We particularly need to see how we can free up more time to deliver the personalised care that patients deserve and meet the challenges from an increasing number of older patients who need coordinated and effective care.’

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