GPs face unsustainable pressure, warns GMC report on doctors' wellbeing

GPs are working under intense and unsustainable pressure that has eroded their relationship with patients and standards of care, according to a GMC report that calls for reforms to improve doctors' wellbeing.

Heavy workload is leading to GP burnout and has increased doctors' risk of making mistakes, the Caring for doctors, Caring for patients report warns.

It found that ‘relentless seven- to 10-minute consultation times [were] stressful for GPs and not productive for patients’, and made it hard for practitioners to take breaks.

Clinicians felt obliged to work more than their contracted hours to ensure patients received the care that they needed, it warned, with GP partners particularly affected.

GP workload

Meanwhile, around nine out of 10 GP trainers in the UK worked beyond their normal hours on at least a weekly basis - a much higher proportion than trainers in other specialties.

Limited opportunities for GPs to learn or develop was found to be contributing to many retiring early. Authors highlighted that GPs were effectively asked to do the same tasks without opportunities for development for often well over 30 years, contributing to lower job satisfaction.

The report comes three weeks after another GMC report revealed that half of GPs felt ‘unable to cope’ with their workload, while 36% reported having reduced the number of hours they worked in clinical practice over the past 12 months.

The latest report calls for the GMC to work 'with UK national governments to develop strategies to better support the ongoing development of all doctors outside or after formal postgraduate training, and, in particular, GPs'. It adds: 'This should establish new ways of working to improve the capacity and confidence of newly qualified GPs and specialists and the retention of experienced doctors in the NHS.'

Supporting doctors

Recommendations also call for work to reduce unnecessary tasks that do not benefit patients and undermine doctors' wellbeing, and says that primary care networks can help create a more supportive environment for GPs.

'With the advent of primary care networks in England, it should be a priority to develop supportive teams enabling peer coaching, social support, mentoring, quality improvement initiatives and action learning groups,' the report says.

'With the scale that primary care networks will create, it will become easier to build effective multidisciplinary team working.'

The report's authors said many individual employers and clinical teams were ‘already implementing local solutions to address issues affecting the health and wellbeing of doctors’.

In one case study, managers reduced workload by developing the GP role, transforming them into effective leaders of multidisciplinary teams who dealt with complex consultations.

Appointment duration

By recruiting pharmacists, paramedics and nurse practitioners to take on some of the GP workload, family doctors at the practice now have 15 minutes for routine appointments.

Meanwhile, a group of GPs in Leicestershire helped to boost confidence and increase a sense of working inclusively by making time to discuss cases as a team. This approach helped to ‘significantly reduce’ referral rates, the report said.

Co-chair of the review and leading organisational psychologist Professor Michael West, said: ‘Working in primary care exposes GPs to pressures that differ from those in secondary care, but that are no less important and potentially harmful.

‘The numbers of patients they see can be unsustainable, leaving GPs with too little time to catch up on other tasks. These pressures can also damage their relationships with patients, who sometimes feel they are being dealt with in a cursory way.

‘But general practices are developing new roles and working in primary care teams to better support GPs.’

GMC chief executive Charlie Massey, said: ‘Medicine has always been a high-pressure career, but doctors are telling us that the demands on them are now so great they risk becoming unmanageable. As a result, their own health suffers, and patient care is compromised.

‘Solutions are not easy, but this report shows that there are already many examples of great practice to build from. As a regulator, we will use all our influence and powers to support doctors and medical students.’

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