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GMC warns of 'state of unease' amongst doctors

Its annual report highlights 'dangerous levels of alienation' felt by trainees

Mark Gould

Thursday, 27 October 2016

In its annual report,* the GMC raises serious concerns that a "state of unease" exists within the medical profession as services throughout the UK come under increased pressure.

It warns that systems of healthcare and the health professionals working within them are "struggling" to cope with a range of issues – including the impact of health services under pressure and fragile social care services.

In their introduction to the report, GMC chair Professor Terence Stephenson and chief executive Niall Dickson, highlight a growing pressure on doctors, a "dangerous level of alienation" felt by doctors in training and, the impact which struggling healthcare services are having on doctors’ education and training.

"There is a state of unease within the medical profession across the UK that risks affecting patients as well as doctors. The reasons for this are complex and multifactorial, and some are longstanding. Yet the signals of distress are unmistakeable. There appears to be a general acceptance that the system cannot simply go on as before.

"Everyone wants a health service that is efficient, effective and compassionate. We all want staff to practise in an environment that helps them provide an excellent standard of care and where they are able to raise concerns and are valued for their skills," they say.

The report makes clear the GMC has a role to play in addressing the "state of unease" – by making regulation as light touch as possible, reassuring trainees that they are valued, and addressing the anger and frustration which has built up during the ongoing dispute in England between the BMA’s Junior Doctors’ Committee and the Government.

"There are a host of underlying non-contractual issues, some of them long standing, that have helped to create this dangerous level of alienation among the next generation of medical leaders. This should worry not just those of us close to the medical profession, but everyone concerned with the future of our healthcare system," the report states.

The GMC is exploring how postgraduate training can be made more flexible for doctors and the report says work must continue to reform the way doctors’ education and training is organised. The GMC also wants to play more of a role supporting those engaged in workforce planning – to make sure doctors have the right knowledge, skills and standard of behaviour to serve patient needs in the years ahead.

The report is keen to assure patients that the standard of care provided by doctors remains among the best in the world. The GMC’s data for 2015 shows that it received 7% fewer complaints about doctors compared to 2014 and the vast majority of doctors were not complained about to the GMC. The report also shows the profession is becoming more ethnically diverse, and the proportion of female doctors is edging closer to making up 50% of the medical register.

NHS Employers said it welcomed the insight the report gives into the "huge financial and service pressures the NHS is under" and how insufficient funding in the whole care system is putting increasing pressure on frontline staff and patients. "We need the Government to incentivise greater coordination between local authorities and the NHS and to invest more in out-of-hospital health and care."

Katherine Murphy, chief executive of The Patients Association, agrees that doctors, nurses, and other NHS staff are "under incredible amounts of pressure" because they are helping more patients, on a smaller budget with less staff support.

"We recognise that many patients have a smooth and positive experience when visiting their GP or hospital. However, naturally, patients will be apprehensive that the GMC has identified a growing state of unease, stress and low morale from doctors nationwide. For the professional regulator to highlight this issue, alarm bells should be ringing in the Department of Health."

A Department of Health spokesperson said: "The dedication and sheer hard work of our NHS doctors is absolutely crucial to delivering world-class care for patients. As the report makes clear, the standard of care provided by doctors working in the UK remains among the best in the world. 1.6 million more NHS operations now take place each year compared to 2010 and hundreds of thousands more people are seen in A&E within four hours.

"The government is investing £10 billion to fund the NHS's own plan to transform services for the future - central to which is listening to the concerns of staff."


* The state of medical education and practice in the UK – 2016. General Medical Council, October 2016.

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