Two in five GP trainees' education undermined by heavy workload, warns GMC

As many as two in five GP trainees face excessive workloads that interfere with their training, according to a GMC survey.

The GMC has warned that trainee doctors are struggling with increasingly heavy workloads, which it says is ‘eroding the time’ they have for training.

Results from the regulator's annual National Training Survey (NTS) found that many trainees feel they are under significant and growing pressure that is ‘threatening the training they need to become the next generation of GPs and consultants’.

The survey – which compiles responses from 55,000 doctors undertaking foundation, GP and specialty training – shows many GP trainees are becoming less satisfied with their daytime workloads, with almost 38% indicating workload was either ‘heavy’ or ‘very heavy’.

GP workload

This marks an almost 5 percentage-point rise since four years ago in 2012, when just a third reported excessive workload.

The findings put GP trainees slightly below the average for all trainee doctors, of which 43% described their workload as above ideal levels – a steady 2.3 percentage-point rise since 2012.

Emergency medicine came in at the highest with 78%, followed by gastroenterology at 60%,

Respondents with excessive workloads had on average twice as many concerns about patient safety in their post and were six times more likely to feel forced to cope with clinical problems beyond their competence.

They were also three times more likely to have to leave teaching sessions in order to answer clinical calls. The GMC warned that this training time must be ‘protected as much as possible’.

More than half of all trainees, including GPs, said they regularly worked beyond their rostered hours during hospital placements, with 25% saying this left them sleep deprived on a weekly basis.

GP satisfaction

Figures from the same survey, released ahead of the main report earlier this year, showed that GP trainees self-report slightly higher satisfaction than the average rate among trainees overall.

The survey also polled 23,000 trainers, with GP trainers reporting that they have more time to dedicate to being an educator than those in any other specialty.

GMC chief executive Charles Massey said: ‘Doctors in training are the next generation of consultants and GPs, and they are telling us, in significant numbers, that current workloads threaten the time they need to train.

‘Poor-quality training, whether it’s to a low standard, rushed or interrupted, correlates with a higher likelihood of patient safety concerns, and with working environments that are not conducive to doctors raising concerns.’

Dr Pete Campbell, BMA junior doctors committee chair, said: ‘We cannot accept a situation where vital training time is being sacrificed in the face of rising pressures on services. This is a short-sighted approach that is already having an impact on the quality of patient care.

‘We need to maintain a highly trained medical workforce if the NHS is to continue to deliver a world-class service for patients, and protecting and valuing training time is absolutely vital to achieving this.

‘This report highlights important concerns around workload, safety and training and reminds NHS employers of their obligations.

‘In order to address the underlying issues highlighted in this report, the government urgently needs to tackle the workload, staffing and funding challenges that are overwhelming our health service and compromising patient care and doctors’ training.’

NHS Employers chief executive Danny Mortimer said: ‘The health and safety of staff and thereby their patients is paramount. Many of the issues highlighted in this report will be mitigated by the new 2016 contract of employment for doctors in training.

‘The new contract sets out improved requirements on working hours and adequate rest periods, while the new independent guardian of safe working hours will play a vital role in enforcing them.

‘At the same time employers and HEE continue to make improvements to the quality of training on offer.’

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