Unfounded accusations that GPs are work-shy or actively avoiding seeing their patients have been a well-worn theme over the course of the pandemic. It seems that GPs have become a convenient scapegoat for every difficulty currently facing the NHS.
The reality is that GPs are working harder than ever and this has potentially serious consequences for GPs themselves and for their patients.
GPs are running on empty
A survey of MDU members* carried out in December 2021 reveals that GPs are running on empty with six in 10 GP respondents saying they feel sleep deprived at work. More than half say their sleep patterns have worsened since the start of the pandemic. In addition, 40% of GPs who responded said they didn’t get a break at all during a working day, compared with 23% of hospital doctors.
Some GP respondents added comments which laid bare their feelings of exhaustion and strain. One said: 'I am supposed to work part time, but I work full time hours to keep on top of the workload. However, this is now impacting on my personal life, I have less time for myself, and my family'.
Another commented: 'There is no capacity in the system to do anything about feeling tired or burnt out.' A total of 24% of GP respondents said that they had suffered poor mental health due to sleep deprivation, while 31% of respondents reported experiencing mood swings.
Alongside the impact of fatigue on practitioners themselves, there are clear implications for patient safety. Countless studies have showed the affect that fatigue can have on our cognition and performance, whether behind the wheel or in the workplace and this was the case for our GP sample too.
When asked about the impact of sleep deprivation on their practice, 58% reported difficulties with concentration; 43% found it harder to make decisions; 25% experienced memory problems; and over a third said they were more intolerant with patients and their relatives.
Perhaps the most disturbing aspect of our survey was that over a quarter of GP respondents said they had felt so tired at work they believed their ability to treat patients was impaired with a further 17% believing tiredness may have affected patient care.
In a small number of cases this resulted in harm to a patient. While this represents a tiny proportion of the GP interactions that take place every day, the MDU is concerned that the number of adverse incidents in general practice could increase if doctors receive insufficient support. Our survey showed that half of GPs use caffeine to see them through spells of extreme tiredness.
Of course, we know there are no easy solutions in the context of a pandemic which continues to deplete staff levels and drain NHS resources but we urgently need action to reduce the administrative burden on GPs, reverse the decline in GP numbers and fund the recruitment of more practice staff to support clinicians.
It is essential that practices are not forgotten amid the additional resources, being made available for hospital services. Improved communication pathways and easy access to advice from hospital colleagues would also help GPs to better support patients who are waiting for longer than usual for specialist review/treatment.
There must also be an end to the hostile rhetoric directed against GPs at a time when violence and abuse against healthcare professionals is increasing and more clinicians are leaving general practice.
The MDU survey highlights the lack of support for GPs who are working under huge pressure and the significant constraints imposed by the virus. If this doesn’t improve, the consequences for doctors and patient safety could become one of the most toxic legacies of the pandemic.
* The MDU surveyed a sample of doctors in December 2021. The 532 respondents (6% response rate) included: consultants & specialists (38%), GPs (33%) and specialty/career grade hospital doctors (27%).