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The waiting game

Journal publishes study into Pulse readers' comments on GP news

University researchers have analysed hundreds of Pulse comments to understand GPs’ views on health policy changes.

The study, published in the BJGP, found that GPs feel ‘criticised, undermined, and attacked’ by the Government and patients, as well as ‘let down’ by professional organisations such as the BMA and RCGP.

Researchers from the University of Manchester analysed 300 comments published on Pulse articles between January 2012 and March 2016.

They found that among commenters there was consensus that general practice was ‘under-resourced and stretched’, and that GPs were often ‘working to meet demand for access in a pressured environment’. 

However opinion was divided in terms of who to blame, with the government and patients both being mentioned.

Contributors also resented the constraints on their freedom to practice, which they said have been ‘imposed by excessive bureaucracy’ and a pressure to meet ‘patient demands’.

Additionally many comments suggested that rather than being respected, GPs now felt ‘criticised, undermined, and attacked’ not only by the government, but by the private sector and patients. 

However, while numerous contributors expressed very little possibility of positive change, others called for GPs to stand up and 'take back control'.

Study author Professor Damian Hodgson, a professor of organisational analysis at the University of Manchester, said: 'Given the huge pressure on general practice currently, there is a real need to ensure that the voice of GPs is heard, and in particular to hear a variety of voices within the field and the profession.

'The level of discontent found among GP commentators to the Pulse is perhaps not surprising; what is more striking is the degree of powerlessness and frustration expressed by rank and file GPs.'

The analysis also revealed a sense of ‘being let down’ by professional organisations such as the RCGP and BMA. 

GPs expressed ‘disappointment and lack of faith’ in the ability of these organisations to ‘protect the welfare of GPs or meet their needs’ in terms of their wellbeing and professionally.

A BMA spokesperson said: 'While member satisfaction with the BMA remains high we recognise the frustrations felt by many GPs, and more needs to be done by government to tackle the pressures caused by rising demand and increasing workloads.

'The BMA is committed to representing and negotiating on behalf of doctors across the UK and the recent successful negotiation of the 2018/19 GP contract in England, which secured £256 million to address practice pressures, builds on our progress from the last two years to provide stability to practices at a time when it is needed the most.'

A spokesperson for the RCGP said: 'The BJGP is an independent academic journal and the authors are entitled to their opinions. The college will continue to campaign on the issues that matter most to frontline GPs, including wellbeing, workload and workforce, and to support all our members in their care of patients.'

The paper concluded that the ‘ambivalence’ shown by GPs deserves ‘further attention’ as it could potentially shape responses to further change in primary care in ‘unpredictable ways’.

It added that these findings could also ‘help guide policymakers and professional leaders in their GP workforce endeavours’.

Earlier this month the Government revealed that nearly 700 GPs have sought early retirement due to ill health since 2010.

Health minister Steve Brine said that over 5,000 GPs retired before the age of 60 between 2009/10 and 2016/17, with 684 of these being due to ill health and 4,753 down to voluntary retirement.

GPs’ views of health policy changes: a qualitative ‘netnography’ study of UK general practice online magazine commentary; BGJP, 23 April

Readers' comments (21)

  • The fact that this study gets published in the BJGP (an RCGP publication) just shows the lack of quality of research. While I am likely a contributor to the analysed responses, 300 comments on a Pulse website cannot remotely reflect other than a highly self-selected group of GPs who are likely unhappy with current conditions. Quite how any conclusions can be drawn from this analysis escapes me - other than "Many Pulse contributors are angry". I didn't need a research grant to prove that.

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  • Lets redress the balance a little.

    "There has never been a better time to be a GP".
    "There has never been a better time to be a GP".
    "There has never been a better time to be a GP".

    Repeat another 297 times.

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  • I agree with the findings. Where were they published and how much official and academic attention does anyone think it got!

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  • Agree quality of evidence is poor though!

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  • shame you've got to pay $35 to read the article if you don't belong to the cardigan club

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  • AlanAlmond

    Interesting to hear the response of the RCGP who dismiss it as ‘the opinion of the authors’. Urrr actually it’s an analysis of the opinions of a group of GPs posting comments on PULSE, not the authors. Typically concieted and detatched.
    OK so it’s not a randomised control trial but qualitative reasearch like this has a role to play in the general discussion. If nothing else’s it demonstrates that people read the comments on PULSE, that to me is marvellous news. Social media plays an increasingly important role in how our society debates issues. Like it or not it’s a fact of today’s world. At least somebody is paying attention. Why wouldn’t that be a good thing?

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  • The GP posters on Pulse are almost universally and consistently disgruntled. They once aspired to more than shabby and buttons.

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  • Vinci Ho

    (1) There is nothing to be ‘proud’ of for an academic paid attention to study the comments on this platform and published that in the college’s ‘throat and tongue’ journal. If somebody was cynical enough , he/she would label the comments as cathartic , disruptive and unhelpful rantings.
    (2) But the reality is , as I wrote before , many political aides and ‘groups’ are probably monitoring this platform everyday . My conspiracy theory beacon was even beaming for the possibility that some of them had already infiltrated among this cohort.
    (3) These kind of comments under published articles are nothing new , whether it was in newspapers or here on an electionic platform. It begs the simple question of ‘ what is the fuss of bothering about these comments.’
    Frankly , if everything is in order in general practice, nobody would really want to pay much attention seriously to what we wrote here . No need really.
    It is , otherwise , a sad , sad story for us to raise the attention of politicians, stakeholders, academics, regulators and technocrats, in such a raw and primal fashion. For these people , shame(not even sorry) is the hardest word to say . On another tone , it is totally understandable that many of us are so disappointed of those representing us to oversee the government , hence, the check and balance.

    Of course , we should not underestimate the great works done by the three latest editors of Pulse ; Steve , Nigel and Jaimie......

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  • Less negativity and more positivity - GP is the best job in the World - and we have a choice of countries to emigrate to where, unlike in the UK, this remains true.

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  • Steve Brine-isn't he the complete Tory pilchard who complained that GPs were putting off recruitment because we were telling the truth about ambient NHS working conditions?

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  • ....and to paraphrase Groucho, I wouldn't want to read any paper that had me as a contributor.

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  • AlanAlmond

    This is a newspaper. It exists to air views and stimulate discussion. The views have been aired and discussion has been stimulated. I dispair at the myopic outlook of some in this profession. If you think someone commenting on your comments is in error, why on earth did you comment in the first place? It beats me. To those who think this is somehow another sign of impending doom I suggest you try break out of the cardboard box your living in, and if you don’t want to, why not bed down in the corner and keep quiet. Your comments are apparently pointless.

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  • Typical RCGP response. Ultimately it’s down to us. Only GPs can change the mess we find ourselves in. We have to do this by raising our profile and pushing back. We need to start by setting a maximum workload limit. This will then set a value to a GP appointment which currently has little or no value as they’re seen as a limitless supply.

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  • Criticised, undermined and attacked?

    Sounds bang on to me.

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  • Took Early Retirement

    The RCGP is a pathetic joke to many of us. DOI- so p***** off was I with their inability to even get my address right that I gave up both my membership AND fellowship. Their journal is just full of fuzzy pseudoscience- "what patients think about x" summarizes most of the "research" it publishes. Drivel. Utter drivel.

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  • Took early retirement.Spot on.

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  • An absolutely useless survey from which to try to generalise. It breaks the fundamental rule of statistics: ensure your sample population is representative of the population you are trying to study.
    Yes, it's probably a well-analysed report of what this very self-selecting group of people have said (and WITHIN THESE CONSTRAINT is likely to be accurate and valuable), but under no circumstances can it be extrapolated to the GP population as a whole.

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  • The recruitment problems, golden hand shakes etc speaks volumes so it is not just a select group of GPs. Has anyone heard of a happy GP in these climate? Barwa Garba, GMC, CQC, all the cuts with the government washing their hands (escaping the sinking Titanic) and making all of us pay to shoot ourselves in the foot in the hypocritical name of keeping standards up.

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  • Actually, people like myself love the NHS and the concept of universal care. Sadly, we see the disintegration and we find it appaling. We are not a small disgruntled minority.
    We are recruiting in India and the European Union, doctors are leaving early, practices are closing.
    Even Prof Stephenson of the GMC acknowledges it is like soldiers going to war.
    As Dr Eileen Parkes in her award winning article states his answer is to give Resilience training ie Fix the doctors, not the situation.
    Prof Stephenson is right in this, It is like war without an end, at least poor soldiers do get a time of peace.
    Therefore, it is not us miserable sods that are complaining of an non existent problem, but a problem that leave patients without access to timely and proper treatment.
    Treatments so delayed it costs misery and lives. It is not healthcare to spend 36 hours on a trolley in an A+E corridor or wait 6 weeks for a GP appointment.

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  • RCGP/BMA 'member satisfaction' remains high : because all the sensible doctors have resigned from these out-of-touch organisations. Why pay so much for such rubbish representation?
    The RDA does much better!
    Otherwise MPU, for those remaining in GB.

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