Four in five GPs report heavy workload as COVID-19 second wave builds

Four in five GPs say their practice is currently facing levels of workload that are above normal - with rising demand for consultations, the strain of remote patient contacts, staff absences and the backlog of NHS treatment adding to pressure as a COVID-19 second wave builds in the UK.

GP workload (Photo: sturti/Getty Images)
GP workload (Photo: sturti/Getty Images)

A total of 81% of GPs say workload at their practice is currently above normal levels, a GPonline poll reveals, with more than one in three GPs overall describing current workload as 'very high'.

Among GP partners, a staggering 94% reported that current workload was above normal levels - with half of all partners who took part in the survey warning that workload was 'very high'.

Rising demand for consultations, the significant workload involved in delivering large numbers of patient contacts remotely, work dumped from hospitals onto primary care, a surge in clinical administrative work and the knock-on impact of the NHS backlog created by the COVID-19 pandemic were highlighted as key factors driving heavy practice workload.

GP workload

Findings from the poll highlight the intense pressure on primary care at a time when the UK faces a growing second wave of coronavirus infections - with record numbers of daily cases confirmed last week and millions of people across the UK facing local lockdowns.

The poll also echoes evidence from the RCGP's research and surveillance centre - which has reported figures showing practice workload surging in recent weeks. GPonline analysis of the RCGP data earlier this month found that the overall number of consultations practices are providing is now in line with pre-pandemic levels - and that once clinical administrative tasks are factored in, overall workload is higher.

GPs responding to the survey said the heavy workload facing the profession made criticism over access to GP appointments even more galling. One respondent said she was 'sick of being criticised by the media' after negative coverage triggered by an NHS England warning that practices failing to offer face-to-face care when appropriate could be in breach of their contracts.

Another respondent wrote: 'The workload is skyrocketing and meanwhile we are getting told off like naughty schoolchildren for not seeing patients.'

Face-to-face consultations

Findings from the GPonline survey came as the RCGP published a statement to 'set the record straight' after the Daily Mail reported on patients 'who needed a GP slot' being 'unable to get one face-to-face'. RCGP chair Professor Martin Marshall said: 'While there was a temporary drop in demand for GP appointments at the peak of the pandemic, GP consultation rates are now back to near-normal levels, and the proportion of GP face-to-face consultations is significantly increasing.'

Seven out of 10 GPs responding to the survey highlighted rising demand for appointments among key factors driving practice workload - and two thirds of respondents said 'consultations now take longer'.

One GP said: 'It gets very busy as admin work takes a long time and the consultation volume is high as well. It takes longer to assess patients on telephone consultations, to decide if they need to be seen in person.'

Another GP said: 'Telephone is not a quick option. Approximately one third of patients are not available on the first call. Often have to ring several times. Then there is a bizarre mix of patients demanding face-to-face when often not necessary based on symptoms and others refusing face-to-face when needed.'

Hospital care

More than half of GPs overall and more than seven in 10 partners reported workload transferred inappropriately from hospitals adding to practice workload, while similar proportions warned that the knock-on impact of delays to NHS treatment during the pandemic had added to pressure on primary care.

One GP reported: 'Constant workload dump from hospitals - they are doing even less than usual due to the pandemic, asking GPs to prescribe for them, arrange tests for them, review patients for them and report back etc. Hospitals are treating GPs like their community servant.'

Around one in four GPs said staff shortages were adding to workload - with a third of partners warning that staff shortages linked to the COVID-19 pandemic had increased pressure. Respondents highlighted the impact of staff who needed to shield, and the impact of staff unable to come in to work because they or a family member needed a COVID-19 test and had struggled to access one rapidly.

GPs also highlighted the impact of the rapid change in ways of working as general practice adapted to the pandemic - and how it had affected both patients and staff. One GP said: 'The workload is changing. The volume of telephone calls is exhausting. The nature of clinical contacts is changing - and we are having to deal with a lot more angry and frustrated patients.'

Responding to criticism of GPs, Professor Marshall said: 'Throughout the pandemic general practice has remained open and GPs and our teams are working hard to care for both COVID and non-COVID patients.

'GPs are following government guidance and have done everything they’ve needed to do to minimise the spread of the virus and ensure the safety of patients and frontline health professionals.

'We understand that some patients prefer the face-to-face personalised service that they are used to - and that many GPs also prefer this way of consulting. However, the challenge of infection control isn’t going away and there has been a rapid rise in the number of people testing positive for COVID.'

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