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CAMHS won't see you now

Commissioning advice inadequate, say GPs

GPs' morale has improved from the rock bottom levels seen before the new contract. But the gains are under threat from spiralling workload, Government-funded research concludes.

The study of 1,035 GPs carried out on the eve of the contract found lower stress levels and slightly better overall job satisfaction than in a previous survey in 2001.

But GPs were still plagued by concerns over workload, loss of autonomy and time pressures and said they expected the contract to make many things worse instead of better.

Despite the prospect of giving up out-of-hours work, the majority of GPs surveyed by the National Primary Care Research and Development Centre in February 2004 anticipated an increase in hours and a decrease in professional autonomy.

The research, which is carried out every three years, also found GPs were anxious about increased paperwork, a lack of recognition for good work and pay.

One-fifth of all GPs said they were likely to quit within five years, a level unchanged from the 2001 study.

Professor Bonnie Sibbald, deputy director at the centre and author of the study, said maintaining the improvements in GP morale depended on a marked reduction in time pressures and giving GPs more control over their job.

GPs gave mixed views on whether the new contract was delivering this.

Dr Kailash Chand, GPC member and a GP in Manchester, said there had been 'a sense of euphoria' going into the contract that it would enable GPs to give up work they did not want to do.

'But the euphoria has not lasted,' he added. 'A real concern is that the contract may put an end to the generalist GP, which will affect job satisfaction.'

Dr Adam Greig, a GP in Bracknell, Berkshire, described the contract as an 'intrusive, bureaucratic nightmare', with unrealistic targets. 'For salaried GPs who turn up to do shifts the new contract is probably very satisfying but to principals it is not,' he said.

In contrast, Dr Michael Taylor, chair of the Small Practices Association, said morale among singlehanders may be improving because of benefits from the contract.

By Joe Lepper

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