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GPs ‘too exhausted’ to provide out-of-hours care

Unattractive pay is also cited as a reason in survey published by BMA Wales

Jo Carlowe

Wednesday, 24 January 2018

Exhaustion caused by daily pressures is the main barrier preventing GPs in Wales from providing out-of-hours services, a new survey* has found.

The survey (released today) saw 64.3% of respondents cite exhaustion as the main barrier for not providing the service. Some 38.1% of respondents also cited unattractive pay rates as a reason.

GPs have been able to opt-out of providing out-of-hours services since 2004.

The survey also asked GPs what action should be taken following the implementation of HMRC guidance following Health Boards in Wales making changes to the taxation status of doctors who work out-of-hours. Health Boards now consider these doctors as being “employed” for taxation purposes only and not for employment rights purposes. This means that GPs are not entitled to benefits such as annual leave, study leave, sick leave or maternity leave – creating a further barrier to out-of-hours working.

Responding to the survey results Dr Charlotte Jones, chair of General Practitioners Committee Wales said: “These results aren’t surprising and confirm what we have known for some time. The pressures that GPs face day in, day out are leaving them exhausted. This exhaustion can ultimately lead to burn out and GPs leaving the profession early, further compounding the problem.

“The system as a whole is under a sustained amount of intense pressure, brought about by an increase in workload and inadequate resources due to years of under-investment. This is a significant problem facing in-hours services but is particularly acute for out-of-hours services, meaning out-of-hours is viewed as an unattractive place for GPs – who despite everything continue to provide high quality services for their patients – to work.”

She added: “Changes to HMRC regulations and the way each Health Board is implementing the changes has led to GPs who do work out-of-hours feeling undervalued and not appreciated.

“If a person is considered employed for taxation purposes, then they should be considered employed for all purposes and should receive the same benefits as others who are employed such as paid annual leave and sick leave.”

Dr Jones called for ‘true investment’ in out-of-hours services to ensure patients receive a ‘safely staffed service’.

She said: “To ensure that out-of-hours services are fit and prepared for the future it needs to be made an attractive place for GPs to work. This can be achieved by tailoring offers to the needs of individual GPs – providing increased pay rates or a full or zero hours contract depending on the needs of the individual doctor. Above all, GPs who work out-of-hours need to feel that they are a valued member of the workforce.

“If urgent action is not taken, patient care will be impacted. Services will continue to be inadequately staffed, and in some cases not staffed at all, which will lead to longer waiting times; reduced appointment availability and a need for patients to travel longer distances to access care. One of these issues alone would have an impact but together will inevitably add considerable pressure onto colleagues in practices, secondary care and the ambulance service.”

*BMA Cymru Wales GP Out of Hours Survey Winter 2017. A survey conducted by BMA Wales, January 2018.

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