GPs need 'distress signal' to protect patients from doctor fatigue, says RCGP

Practices under extreme workload pressure should be able to sound a distress signal to the rest of the NHS to protect patients from doctor and staff fatigue, the RCGP has proposed.

Dr Maureen Baker: 'Fatigue among GPs is building up and over time this could have a devastating impact on patient care'
Dr Maureen Baker: 'Fatigue among GPs is building up and over time this could have a devastating impact on patient care'

In a paper to ministers and health officials to be published later on Wednesday the college says that unlike other safety critical sectors GPs have no mechanism to declare when they feel overwhelmed or struggling with fatigue. This could have a ‘potentially disastrous impact on their ability to deliver safe patient care’, the college said.

The paper says that fatigue among GPs is becoming so prevalent it could jeopardise patients' safety on a widespread scale unless urgent action is taken.

The college consultation paper proposes: 

  • Regular, mandatory breaks for staff to minimise the possibility of errors.
  • A mechanism to identify practices under extreme workload pressures – and for measures to be urgently implemented to relieve these pressures.
  • A full-scale review of how daily pressures in general practice can be reduced – including ways in which existing bureaucracy and unnecessary workload can be safely cut. 

Earlier this month the GPC wrote to NHS England calling for practices to be able to declare a capacity shutdown in response to a ‘major incident’ and have the power to close their patient list and access emergency resources. 

GPC chairman Dr Chaand Nagpaul warned that significant numbers of practices are on the brink of collapse and could be forced to close without emergency support. 

RCGP chairwoman Dr Maureen Baker said: ‘GPs will always work in the best interests of their patients – even when they are putting their own health at risk – but ironically this can actually have an adverse effect on patient safety.

‘Few of us would voluntarily board a plane flown by a visibly tired pilot or get on a train where we knew the driver had spent too much time at the controls – yet there are no methods or systems for addressing doctor and staff fatigue in general practice.

‘Even in other areas of the NHS, ‘distress signals’ – such as red and black alerts in hospitals – exist so that other clinicians can simply declare that they cannot take on further work safely. 

‘But unless we disrupt patient services – which is the last thing that GPs want to do – we currently have no strategies in place to prevent and reduce the risk of patient harm that might arise from having tired overworked doctors and practice staff.

‘With waiting times to see a GP now a matter of national concern, our members are routinely working 11 and 12 hour days in surgery to try and accommodate. You might be able to do this for a short time, but when it becomes the norm, mistakes are going to be made.

'Fatigue among GPs is building up, to the detriment of their own health, and over time this could have a devastating impact on the care that our patients receive.’

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