Working as a full-time GP in clinical practice is becoming unsafe, RCGP chair warns

The government needs to understand that general practice is a 'safety critical occupation' and it is now increasingly difficult for GPs to work full-time in general practice if they are to practise safely, the RCGP chair has said.

RCGP chair Professor Martin Marshall

Speaking during a Question Time debate at the RCGP annual conference in Liverpool. Professor Martin Marshall said that the proportion of GPs' time working in clinical practice had dropped from about 86% five years ago to around 67% now.

He said the reason behind this was increasingly because 'the nature of general practice has become so intense and so stressful it's really very difficult for anybody to work full-time extended days'. Professor Marshall said that a 'part time' three-day week 'usually means pretty much 40 hours'.

Earlier this week media critics called for GPs to work a minimum number of hours a week to repay training costs – despite medical students paying tens of thousands of pounds in tuition fees.

The reports on GPs’ working hours came after sustained media attacks over access to face-to-face appointments. However, GPs have warned that criticisng doctors for working less-than-full-time risks driving people out of the profession.

Safety critical occupation

Professor Marshall told the conference that while attending the Conservative Party conference last week he had 'a very unpleasant conversation with a senior Conservative Party politician'.

'He said "why don't you just tell your GPs to work harder?" Professor Marshall revealed. 'After I'd picked myself up off the floor, I pointed out to him that forcing people to work more days in a week, when they're already feeling vulnerable – and they're already concerned that the pressures of the job are going to risk them making diagnostic errors and prescribing errors – is just a complete nonsense.

'Pilots [only] fly for 32 hours a week, and they do that because they're in a safety critical occupation. We're in a safety critical occupation as well, and we need the same understanding.'

Dr Becks Fisher, a GP and senior policy fellow at the Health Foundation think tank, told the conference that in order to 'shift the narrative' around part-time working the NHS needed to get better at counting the number of GPs and how they worked. 'Our workforce numbers are currently a bit of a shambles,' she said.

GP bashing

Dr Fisher said the profession also needed to 'be clear about what we do, what we bring and how hard we are working'. 'It's hard to do that in the current media climate, but I think patients do understand,' she added.

But she argued that it wasn't up to GPs to change the narrative around part-time working.

'We need to be busy delivering the best care to patients, and the responsibility for this narrative and for shifting it needs to be with government,' Dr Fisher said. 'It absolutely blows my mind that at a time we need to encourage people into this profession, the government is driving this anti-GP rhetoric and GP bashing. And that has to change.'

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