Exclusive: Burnout service helps more than 800 GPs stay in work in its first year

More than 1,100 GPs have sought help from the GP Health Service since it was set up a year ago to support doctors facing burnout, depression or addiction - and 75% are currently in work, GPonline can reveal.

GP Health Service lead and former RCGP chair Professor Clare Gerada (Photo: Pete Hill)
GP Health Service lead and former RCGP chair Professor Clare Gerada (Photo: Pete Hill)

GPonline reported last month that three doctors a day had sought help from the service in its first 10 months, and official figures confirm this rate continued throughout its first full year.

A total of 1,109 GPs chose to access the service in the 12 months from its launch on 30 January 2017 - just over three per day. Numbers of GPs coming forward for help exceeded forecast levels by 15%, GP Health Service officials have confirmed.

The figures reflect rising pressure on general practice in recent years, with GP numbers in steady decline, practice closures at record levels and GP leaders admitting that many practices have simply given up trying to fill long-term vacancies.

Most cases seen by the service involve stress, anxiety and depression, with around 15% coming forward with 'more significant mental health conditions' and about 2% involving addiction. Just over two thirds of GPs coming forward for help (67%) are women, and around half of the service's caseload is aged between 30 and 40 years old.

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The service is led by London GP and former RCGP chair Professor Clare Gerada, who has also been running the Practitioner Health Programme (PHP) - a service offering support to London doctors - for almost a decade. She said the PHP scheme had probably seen one in 10 doctors in the capital in its near 10-year lifetime, and that between it and the GP Health Service around 5,000 doctors had been supported to deal with stress or addiction issues.

'What surprised us is how sad it has all been,' she told GPonline. 'To see my hardworking profession - fantastic colleagues - giving their all and continuing to try so hard. I think politicians are beginning to realise we can’t make water from wine – we can’t make miracles. Hopefully change is in the air.'

Even now, Dr Gerada said, many clinicians and managers working in the NHS did not realise that general practice was the 'risk sink of the health service', and that if it failed the service as a whole would not be able to cope.

The work of the GP Health Service was 'about trying to strike a balance for hardworking GPs and making sure they look after themselves, and that in the current climate they don’t make an error', the former RCGP chair said.

GP workload

'I spoke to someone recently, working nine or 10 sessions a week and very long hours. With that workload, errors will be made - as day follows night - and their careers will end,' she warned.

'I think what the GP Health Service is doing is making it ok for GPs to realise they are depressed and telling them that they are not alone.'

Following major media attention on the case of Dr Hadiza Bawa-Garba, struck off by the GMC after a High Court legal challenge, Dr Gerada said people involved with PHP had been 'banging on the GMC's door' for years warning that doctors must be treated better and 'can't be treated as criminals'.

'We have many cases similar to that of Dr Bawa-Garba,' Dr Gerada said. 'Doctors who have made errors and been erased and not made the headlines. She has come at a tipping point. We have pointed out the disproportionate nature of some of the cases.'

Pressure on GPs had reached an intolerable level, she warned. 'It is better that patients wait longer to be seen, than be seen by a tired doctor who may make an error. More and more patients are pitching up at GP surgeries, and we need more GPs spending longer with patients in their communities.'

Clinical freedom

Dr Gerada warned that doctors had 'all the accountability and decreasing authority' as shared decision-making, QOF, protocols and guidelines limited their individual freedom as doctors.

But Dr Gerada said the GP Health Service's big success had been getting primary care doctors back into the workforce. In some cases the service had recommended action at practice level, rather than just for an individual doctor, she said, securing the chance for practices in meltdown to close for a half or full day and 'regroup'.

GP Health Service chief executive Lucy Warner said: 'The key to the GP Health Service is that the total treatment budget is held in one place and so decisions around therapy, specialist support or even admission for addictions can be made quickly through the multi-disciplinary team and GP-patients face minimal delays in accessing ongoing treatment.

'This reduces any time off sick, and for many GPs even if they are off sick at the time of accessing the service they get back to work quickly once they are in treatment.' She said that around 75% of the scheme's caseload were working at the end of January 2018 - equivalent to about 830 GPs.

Cheshire and the south central England regions had experienced 'higher than expected' demand, she said. 'Given that many areas of the country have not had any access to confidential support in the past and taking into account the level of stress in the system it may be that there are still GPs and trainees who could benefit from the services of GPH but have not yet made contact.

'Doctors can self-refer and access the service via the website www.gphealth.nhs.uk, email gp.health@nhs.net or call 0300 0303 300.'

Dr Gerada told GPonline she was planning the first international conference on practitioner health in October this year, under the title 'Wounded Healer'.

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