But we must ensure that implementation of the reforms does not add to the increasing bureaucratic burden upon GPs. While the risk this poses to frontline care and to patients is clear, the real human cost to the GPs themselves is less so.
The combined obligations of Care Quality Commission registration, the NHS transparency initiative (meaning that we will all have to publish quality indicators), revalidation and the additional administrative aspects of GP commissioning will place increasing pressure on those who are already overworked.
It is ironic that measures designed to ensure practice and GP excellence, and to provide top quality care to patients, should present such negative possibilities for those tasked with their undertaking, and as medical director of the practitioner health programme (www.PHP.nhs.uk), a service that cares for doctors and dentists with addiction or mental health problems, I see what happens when it becomes too much.
My experience with the PHP has taught me not only that doctors do not make good patients, but also that they place the needs of their patients far before their own. This is, of course, a good thing, but if we are to continue to increase our demands on healthcare professionals without making allowances for their need for a life outside of work, then we must be prepared for this to impact upon morale, physical and mental health.
Part of the problem is that we have shifted the focus from professionalism and self-assessment, to regulation and performance management; funding is heavily weighted towards protecting the public against the tiny number of doctors who commit misdeeds, as opposed to supporting the majority of doctors to do a good job. Patients expect the best possible care but we must also support doctors to be the best they possibly can be for their patients. As a college, we are doing all we can to ensure that initiatives, such as revalidation and registration, will be as proportionate, streamlined and supportive as possible.
As healthcare professionals we must stress the importance of an appropriate work/life balance. Of course we need to ensure that patients do not lose out but it is equally important that we allow the same for ourselves.
- Dr Clare Gerada is a GP in south London. Email her at GPcolumnists@haymarket.com