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General Practice creaking under strain of workload

Six out of ten GPs considering retiring early as workload crisis hits general practice

Mark Gould

Monday, 24 March 2014

General practice is at crisis point with GPs struggling to cope with rising workload and underfunding, according to Dr Maureen Baker the chair of the Royal College of General Practitioners (RCGP).

“General practice as we know it is now under severe threat of extinction. It is imploding faster than people realise and patients are already bearing the brunt of the problem", she said. She warned that some practices are already shutting down and "this will only get worse unless urgent action is taken to redress the huge and historic imbalance in funding."

She said an RCGP survey found that 62% of 1,007 people questioned thought the number of consultations carried out by GPs each day, believed to be between 40 and 60 in most cases, risks the standard of patient care they provide.

More than a quarter, 28%, said the last time they tried to book an appointment with their doctor they could not get one in the same week.

Four in 10 were worried that the amount of time they have to wait to see their GP could affect their health.

The poll, carried out by ComRes, also showed that 60% of the public want funding moved to general practice from other parts of the health service.

Meanwhile, a BMA opinion tracker reveals that six out of ten GPs are considering early retirement as a result of the stress of rising workload. The poll also finds that despite the pressures they are under, GPs are changing the way they work to provide more emergency appointments.

Key findings include:

  • Almost all GPs reported that their workload was too heavy some of the time, with more than half saying their workload was unmanageable or unsustainable at all times.
  • Nine out of ten GPs said that they regularly worked beyond their regular hours.
  • Over half of all GPs reported their morale as being “low” or “very low”.
  • Almost six out of ten GPs said they had considered early retirement and over a third are actively planning for this decision.
  • Over a quarter of GPs had said they were considering leaving the profession, while almost three out of ten had thought about leaving the profession altogether.
  • Despite these pressures, eight out of ten GPs said they were changing the way they worked to meet demand for more emergency appointments, while half said they were responding to demand for more evening appointments.

Dr Baker said that while general practice deals with 90% of patient contact, it only receives 8.39% of the overall NHS budget. She urged governments in London, Cardiff, Edinburgh and Belfast to take action to address the "huge and historic imbalance in funding".

She said: "For generations, GPs have been the bedrock of the NHS and provided excellent care for patients.

"But we can no longer guarantee a future for general practice as our patients know it, rely on it - and love it.

"GPs are doing all they can but we are being seriously crippled by a toxic mix of increasing workloads and ever-dwindling budgets, which is leaving patients waiting too long for an appointment and not receiving the time or attention they need and that GPs want to give them."

She welcomed government moves to train more medical staff, but called for immediate action "to shore up the service in the next few years, until these new doctors, nurses and support staff come on stream". Management and admin tasks are adding to GPs' workloads, Dr Baker said. "By the time someone has worked 11 or 12 hours and seen 50 or more patients, you get to the stage where it's just not safe to carry on working".

A DH spokesperson said: "We recognise the vital job that GPs do. This is why we have cut GPs' targets by more than a third to free up more time with patients, and are dramatically increasing trainees so that GP numbers continue to grow faster than the population."

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