GP burnout 'greatest barrier' to digital future for general practice, warns former RCGP chair

GP burnout presents the ‘greatest barrier’ to increased adoption of remote and digital general practice services in future, a former RCGP chair has warned.

Professor Dame Clare Gerada (Photo: Pete Hill)
Professor Dame Clare Gerada (Photo: Pete Hill)

Dame Professor Clare Gerada told a Westminster Health Forum webinar that general practice could see a permanent shift to as many as 50% of all appointments starting and finishing online in future - following accelerated adoption of remote working during the pandemic.

Around 75% of all consultations were delivered remotely during the first peak of the pandemic as GP practices rapidly adopted new technology to protect patients and staff from COVID-19 - and although face-to-face consultations have risen sharply since then, the shift in general practice remains significant.

Health and social care secretary Matt Hancock has suggested that all future consultations should be conducted remotely ‘if appropriate’ - and whether or not this is realistic, it is widely accepted that general practice is unlikely to return to the pre-COVID status quo.

GP morale

However, Professor Gerada warned that health bosses must ‘start putting the research and development’ around digital consultations to protect both patients and clinicians - emphasising the importance of face-to-face work for GP job satisfaction.

This comes as a GPonline opinion poll found that more than two fifths of GPs said their relationship with patients has worsened because of changes to the way practices have operated during the pandemic.

The south London GP also called for a communications strategy to ‘challenge the abuse’ suffered by GPs in recent weeks around access to face-to-face consultations.

Statistics from NHS Practitioner Health - the mental illness service for doctors, for which Professor Gerada is the clinical director - reveal that more than 200 GPs a month are seeking mental health support as COVID-19 drives up pressure on the NHS. GPs have also flagged the effects of conducting more remote consultations, arguing it can often take longer and be more tiring.

Pressure on GPs

Professor Gerada said she hoped ‘for the best of both worlds’, but emphasised the importance of face-to-face work for GPs. She said: ‘Probably the biggest barrier to digital going forward isn't patients [not engaging with it], but it's the risk of burnout amongst the profession, and what we miss.

‘Medicine is a relational activity, it's done between people, between doctors and patients, and I miss - as many [will] - the human feeling of seeing, touching, smelling, and sensing my patients in front of me. So hopefully when the world comes back to a space where we are seeing patients [more in practice], we will have the best of both worlds. We will have a digital underpinning, but we'll be able to do face-to-face.’

Dr Gerada said that greater use of remote consulting would allow GPs to use their time ‘more wisely’ and spend longer with patients with complex issues.‘This has to be the priority going forward, and to find the research that fits around it because patients would still like to see doctors face to face. So we have to start now putting the research and development behind digital,’ she said.

Current RCGP chair Professor Martin Marshall recently accused the health secretary of ‘overplaying his hand’ by pushing for total use of remote consultations. MPs recently raised the prospect of a cap on GP consultations during an investigation into burnout of NHS staff.

GP abuse

Professor Gerada also reacted to recent reports of GPs facing increased levels of complaints and abuse from patients. She said general practice alone could not champion the efforts of clinicians and called for a ‘comms strategy’ to combat misinformation.

‘We have to challenge these assumptions, it's no longer enough to expect the RCGP to challenge these [views], or other individual GPs. The whole system has to challenge them from the academy and medical colleges right, through to NHS England.’

A GP practice in Bristol was recently sprayed with an offensive message about the efforts of staff, while a recent MPS poll found one in three doctors have experienced verbal or physical abuse from patients or patients' relatives during the COVID-19 pandemic.

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