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Internal NHS England review reveals stark variation in occupational health support for burnt-out GPs

Exclusive GPs across almost a third of England have no access at all to occupational health services, while the support available elsewhere varies starkly, according to the results of NHS England’s own fact-finding exercise.

The information collected as part of NHS England’s internal review, obtained by Pulse under the Freedom of Information Act, shows a huge variation in provision, with 32% of the 78 legacy PCT areas which were able to provide information having no contracts in place to provide occupational health to GPs or their staff.

Even where services are in place, there is a marked variation in the level of support provided and the funding attached. The 35 areas able to provide figures spent an average of 11p for each patient registered with a GP in the area, with Cornwall spending as much as 31p per patient but Sefton in Merseyside spending just 1p per patient.

The exercise, which was completed in July, saw NHS England investigate the current level of provision to inform an ongoing review into whether occupational health services should be funded across the country. NHS England is currently finalising a nationwide plan to provide all practices with ‘a consistent offer of occupational health services’ for GPs and possibly practice staff, and expects to publish full details by the end of October.

A Pulse survey of 441 GPs last month found one in eight respondents had sought help from pastoral or wellbeing services within the past year, with one GP spending almost £2,000 on private psychotherapy after finding it difficult to handle his workload.

A separate Pulse assessment earlier in the year of almost 1,800 GPs using the validated Maslach Burnout Inventory tool found that 43% are classified as being at a very high risk of developing burnout, with partners and those working in deprived areas particularly badly hit. Pulse is lobbying for better monitoring of GP workload and consistent occupational health support for GPs - taxpayer-funded and nationwide - as part of its Battling Burnout campaign.

In some areas, the NHS England review found that extensive services are in place. In Brighton, for instance, GPs who need support are offered phone and website advice or face-to-face consultations with 48 hours, plus up to six sessions of cognitive behavioural therapy.

However, in 25 of the areas to respond to NHS England’s request for information, no services are provided. The devolved governments in Wales and Northern Ireland provide GPs with occupational health services free of charge, while in Scotland it is provided in some areas.

GP leaders said this variation showed that GPs were not being treated fairly in relation to other medical professionals and called on NHS England local area teams to ensure that occupational health services were reinstated for GPs.

Dr Mark Sanford-Wood, acting medical secretary of Devon LMC, said GPs ‘hugely value’ the NHS-funded service in his region, which includes ‘mental health support, plus other services such as cognitive behavioural therapy’.

Escalations in GPs’ problems have been avoided in some cases, Dr Sanford-Wood said. ‘The cost is a drop in the ocean compared to impact on GPs’ health and the knock-on effect on patient services.’

GPC deputy chair Dr Richard Vautrey said: ‘We think that the provision of occupational health services to GPs and practice staff should be on a par with everyone else in the NHS. GPs should be treated fairly, in the same manner as their colleagues in hospital. We are already aware of the high number of GPs suffering from burnout and stress and occupational health services can help provide the appropriate support for that. It is valuable for providing a range of services, including immunisation.’

RCGP chair Professor Clare Gerada said: ‘GPs are struggling to keep their heads above water – and some are drowning. There needs to be an investment. You need healthy GPs to serve the rest of society, but at the moment GPs’ workload is increasing and morale is going down.’

Readers' comments (14)

  • Why would you expect commissioners to provide Occy Health services to GP's? THey dont provide them for BUPA or Spire or any other private sector providers so why GP's? If practices want Occy Health Services then buy them.

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  • Secure environments GP

    It really concerns me how very little is being done nationally to help protect NHS GPs against burnout with the obvious knock-on effect to patient services. Surely if a similar crisis was happening amongst airline pilots there would be an immediate impetus to provide all necessary occupational health and psychological interventions that are necessary.

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  • Vinci Ho

    Once again , the government is not going to show any interests. ' you guys are already damned well paid , look after yourself , you are part of the big society anyway!'

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  • "Dr Tom Reichhelm, medical director for Malling Health, told Pulse: ‘It is tragic. We have tried to make it work but the funding is just not sufficient. That is a widespread problem - general practice is being squeezed and we had not other choice than to give notice.’"

    Anon 1236 thinks we're a private organsiation and can afford occ health services too.
    Private companies are realising it's impossible to make ends meet without cutting services.
    The only reason NHS GP services are functioning is the dedication of the GPs and their staff to keep soaking up more and more. It's unsustainable and that's why burnout is occuring. It's not about take home pay (which is pathetic for the level of expertise and workload (and I reject the argument 'but your poor patients'-we live in a world where a footballer is worth 85m)) it's about T+Cs and erosion of professional automony and that we cannot practice medicine in 10mins.

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  • What is an NHS GP? No such thing exists. There are thousands of private GP's who happen to supply services to the NHS on a very generous contract.

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  • I agree with anon 5.28. What are the causes of burn out ? If are perceived as private providers by all and sundry, then it is truly time to leave the NHS completely and sell our services back. It is unacceptable that so many doctors are depressed and burnt out. We GPs should regulate our workloads and hours better. Follow the dentists or go legal aid type direction. How can we accept that 43 % of GPs are close to burn out. Let us resign from the NHS.

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  • For goodness sake. Realise that both the NHS and your patients do not value you at all. It really is time to quit the NHS and take controll of your workload and remuneration. Go private. Do it soon.

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  • Anon 9.22pm are you Jeremy Hunt?

    Good idea though.

    I don't think the public and politicians will get cheaper ,higher quality and more accessible care as a result though. Still , we doctors may benefit.

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  • I wondered how long it will take for a troll to come out on this thread.

    Personally no amount of occi health is going to prevent a burnout. Reasonable work load, manageable demands and adequate funding might make a difference.

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  • Anon 10pm. Not Jeremy Hunt. I'm a GP who emigrated due to the increasing misery working in the NHS

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