GP forced to break Ramadan fast for first time in adult life due to workload crisis

A Nottingham GP broke his fast during Ramadan for the first time in his adult life to work longer hours and keep his practice running in the face of staff shortages and workload pressure last month.

Dr Hussain Gandhi

Dr Hussain Gandhi, a partner and trainer at the Wellspring Surgery, wrote on Twitter that he felt he had 'no choice' but to break his fast in early April for the first time since his early teens.

The practice normally operates with between 9 and 11 GPs - but due to what he described as 'a combo of COVID-19, infection control rules, subsequent staff leave, lack of primary care additional workforce and crazy demand', its medical workforce was down to three.

Dr Gandhi said that despite offering over £150 an hour, the practice was unable to bring in locum cover - and that as a result he felt he had no choice but to work long hours to keep the practice running.

Ramadan is a holy month that takes place in the ninth month of the Islamic calendar each year, during which Muslims do not eat or drink during daylight hours. This year it ran from the start of April to the start of May.

Dr Gandhi said that to cope with the exhaustion that comes with fasting and reduced sleep during Ramadan, he often uses annual leave to work half days throughout the period to make sure he feels able to practise safely.

However, this year, during the first week of Ramadan Dr Gandhi said he felt he had no choice but to break his fast to operate safely as he worked long hours to cover staff absences and manage intense demand.

He told GPonline: 'It does feel like a sacrifice. In that particular week I didn't see my children, for example, because of the hours I was pulling in the practice until Friday when I got home.'

GP workload

He added that current levels of workload pressure felt 'considerably worse' than in the past, to the point where he felt 'unsure of the way forward' for general practice.

His comments come after official data last week showed that general practice delivered 4m more appointments in April compared with the previous month, with a full-time equivalent, fully qualified GP workforce that has dropped by 369 over the past year.

A London GP warned this week that a third of appointments currently were for patients facing long waits for hospital treatment. A record 6m-plus patients are on the waiting list for hospital treatment - hundreds of thousands of whom have been awaiting procedures for more than a year - and both the National Audit Office and MPs have warned that delayed hospital care is creating additional work in general practice.

In a reflection of the personal sacrifices doctors in general practice are making to keep the service running under intense pressures, the Rebuild General Practice campaign warned last month that more than four in five GPs have experienced work-related anxiety, stress or depression in the past year.

GP morale

BMA England GP committee deputy chair Dr Kieran Sharrock said: 'The combination of record demand and huge workforce shortages – recently compounded by COVID-related absences – means that GPs are pushing themselves to unsafe limits. They are routinely compromising their personal lives and wellbeing to meet demand and look after patients, and while this demonstrates their commitment to their communities, it is unacceptable, unsustainable and unsafe.

'Stretching themselves in such a way is not only unsafe for GPs, but for their patients – with exhausted, burned-out and demoralised doctors more likely to make mistakes.

'This situation cannot continue. We need support and flexibility, and a collaborative approach from government and policymakers that makes a difference on the ground and eases pressures on practices, allowing them to provide safe, quality care to patients.'

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