COVID-19 struck 'hammer blow' to doctors' wellbeing, warns GMC chair

The COVID-19 pandemic has struck a 'hammer blow' to the already-fragile wellbeing of the medical profession, but presents an opportunity for lasting reform to protect doctors, according to the GMC's acting chair.

GMC (Photo: GMC)
GMC (Photo: GMC)

In a speech this week at the Royal College of Physicians and Surgeons of Glasgow conference, GMC acting chair Professor Dame Carrie MacEwen said wellbeing and the role of the regulator were 'intrinsically intertwined'.

She recognised that the GMC is viewed with 'scepticism and even fear' by some in the medical profession - but argued that the regulator was changing.

'We've been on a journey,' she told the conference. Citing the link between poor working culture, stress and burnout and risk of doctors making mistakes, she said the GMC had come to see 'supporting doctors to deliver first-class care as central to our role'.

Supportive environment

'We want to shift from stepping in when things go wrong, to fostering supportive environments that stop harm from happening in the first place,' Professor MacEwen said.

The comments come as the GMC faces criticism over its continued use of its power of appeal against fitness to practise decisions. The GMC has appealed in more than a dozen cases since the government ruled it should be stripped of the power in the wake of the case of Dr Hadiza Bawa-Garba.

The GMC has also faced criticism for a legal appeal against a court ruling that it had discriminated against a doctor on the grounds of his race, while medico-legal experts say planned changes that would categorise doctors who are ill as 'lacking competence' are unfair.

However, quoting the authors of a piece of 2019 research for the GMC, Professor MacEwen told the conference: 'Patient safety depends on doctors' wellbeing.'

But problems with wellbeing are 'driving doctors out of the profession', she warned - and have been since long before the pandemic. She said: 'There’s no doubt that COVID-19 struck a hammer blow to doctors’ wellbeing. But while these issues have been exacerbated by the pandemic, they were not created by it.'

She added: 'The past 18 months have showcased the extraordinary dedication and professionalism of healthcare workers in the UK. But now uncertainty, care backlogs and continuous high demand are creating a perfect storm for an already exhausted workforce.

Doctors' wellbeing

'These pressures are generating enormous difficulties for patients, and all those involved in their care. For patients, waiting for operations, or even initial examinations, the uncertainty can be crippling.

'For us doctors, who pride ourselves on our ability to make things better, it’s deeply distressing. Not being able to give patients what they need has a cumulative effect, one that undermines patient trust and wears doctors down.'

She highlighted that dissatisfaction and burnout were cited as 'two of the main reasons' for doctors quitting UK practice between 2004 and 2019 - long before COVID-19.

She highlighted problems with poor treatment of doctors both by patients and other doctors - including bullying - and highlighted data showing doctors with protected characteristics were more likely to experience poor treatment.

Bullying

'Disabled doctors more often reported bullying as a factor in why they left medicine,' she said. 'Some religious groups reported higher levels of bullying and harassment. And LGBTQ+ doctors more commonly reported mental health issues.

'Meanwhile, female doctors reported greater burnout. This matters. Not just because bullying, burnout and bad culture are a moral stain on our health services. But because they have a material impact on the number of doctors available to staff them and look after our patients.'

Professor MacEwen said the GMC was working hard to reform its processes, and while it did not expect to be 'popular' it wanted to be seen as 'fair and appropriate' and to show a 'more human face'.

She cited reforms to fitness to practise processes, and 'targets around eliminating two persistent areas of disproportionality - fitness to practise referrals by employers and differential attainment in undergraduate and postgraduate education and training. We are also looking at our own internal processes to ensure no areas of discrimination.'

She said the GMC was clear that a key part of its role was to 'improve the wellbeing of doctors and our profession'. Professor MacEwen added: 'What the pandemic has done is give us the platform to push for progress, providing us with a unique chance to make real, lasting change.'

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