Working in general practice 'like being pelted with rocks', MPs told

Intense pressure on general practice has triggered soaring levels of burnout and stress in the current workforce and is also putting medical students off joining the profession, a senior GP has told MPs.

Westminster: MPs warned over GP workforce (Photo: Francisco Cabeza-Lopez/Getty Images)

In evidence to a House of Commons health and social care select committee enquiry into the NHS workforce, GP Emma Hayward said she was recovering from ‘several months of burnout’ - and told MPs of the ‘human cost of GPs having to work in this highly pressurised environment’.

She said: ‘I've never seen my colleagues, so many of them, close to burnout or working while burnt out in the last couple of years. One of my friends the other day described a day in general practice as like being pelted with rocks, because you never know which rock is going to come and hit you and hit you hard, because we are left carrying all the risk for system failures.’

Heavy pressure on GPs has led to reports of large numbers of doctors facing burnout and unsustainable workload. Polling by the GMC last year found that more than half of GPs are struggling with workload and a third are at ‘high risk’ of burnout.

GP burnout

Dr Hayward told MPs that the health service faced a 'massive problem' down the line because medical students were also being put off careers in general practice, after seeing a stressed workforce first hand during placements in practices and seeing media coverage of the problem.

The Midlands GP, a clinical teacher at the University of Leicester, told MPs: ‘Medical students are coming through and they're seeing a stressed and burnt out workforce, and then deciding against general practice.

‘I spoke to my tutees yesterday, year one and year two students, and many of them have already dismissed general practice as a career because of what they've read and what they've experienced. This is a massive problem that we've got to address.’

Dr Hayward said the highly stressful environment in general practices undermined GPs' ability to support and work with potential new recruits.

Workforce

'It impacts our ability to be good trainers,' she told the committee. 'It impacts our ability to be good role models for medical students. So medical students are coming through and they're seeing a stressed and burnt out workforce and they're deciding against general practice.’

Dr Hayward told the committee that general practice remained the backbone of the NHS - and the 'envy of the world' when it worked well. She said: ‘When general practice is adequately resourced and working well, everything else works more smoothly, and actually people around the world envy our system of primary care because it does work so well.’

However, she added: ‘We never see celebration of general practice in the media at all. We only ever see the negatives and that's what my medical students pick up on.’

Her comments follow warnings from other primary care experts over the impact of public criticism of GPs, particularly over face-to-face consultations during the COVID-19 pandemic. Medical Schools Council co-chair Professor Malcolm Reed suggested last year that smear campaigns against GPs had ‘very damaging’ effects on the desirability of general practice as a career choice.

GP success

Despite intense pressure on general practice during the pandemic, there have been notable successes - in terms of rising patient satisfaction and the profession's leading role in delivering an unprecedented COVID-19 vaccination campaign.

Financial watchdog the National Audit Office singled out general practice as the most popular and cost effective part of the COVID-19 vaccine campaign, delivering a far greater share of jabs than anticipated at lower cost than other delivery models.

Meanwhile, patient satisfaction with general practice reached a three-year high last year - contradicting the negative portrayal of the profession from politicians and parts of the media.

Dr Hayward also raised practical suggestions on how students’ experiences and preparation can be improved when entering general practice. 

She said: 'At Leicester, we completely rewrote our curriculum and almost doubled the amount of exposure that our students had to general practice just because we're cognizant of the workforce issues and needing to encourage them, and give them meaningful placements in general practice.

‘If we continue this and further expand training within primary care from graduates, we need to pay attention to the practical issues. General practices are dispersed, not easily accessible by public transport - our students are paying something like £400 over the course of 8-12 weeks, and that is an extraordinary thing to ask our future doctors to do. And so we need to pay more attention to travel and accommodation for those dispersed placements.’

Despite concerns over medical students being put off, GP trainee numbers are currently at record levels after an expansion of training posts in recent years. However, the overall GP workforce remains in decline.

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