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Independents' Day

More bureaucracy, less time to see patients and a profession on the brink: GPC survey results to form crux of contract negotiations

A major GPC survey showing a profession suffering under the weight of bureaucracy, falling resources and low morale since the imposition of the new contract will be a vital part of GPC’s negotiating strategy for the forthcoming contract talks, GP leaders have revealed.

The survey of 3,692 GPs, which is Dr Chaand Nagpaul’s first major imprint on the GPC since becoming chair in July, reveals the extent of the devastation caused by the contract imposition in April, with 82% of respondents saying they have had to reduce the number of appointments available since April, 97% reporting that bureaucracy and box-ticking had increased in the past year and 94% reporting an increase in workload.

GPC leaders confirmed that the survey findings would form an ‘important part’ of negotiations with the government over the new GP contract.

GPC deputy chair Dr Richard Vautrey said: ‘The findings echo what we´ve been saying for some time that GPs are heaving under the workload they have and that matters have been far worse since the imposition of the contract last year. Those factors need to be taken on board now and this will be an important part of negotiations. You can´t put more and more work on GPs or you risk undermining patients care as this survey shows.’

The results – which are based on responses from 10% of the total GP population - also revealed that 89% of GPs believe that more targets will not improve patient care, while 86% reported a reduction in their morale in the past year and 45% said they are less engaged with the CCGs because of increased workload.

This comes as Pulse revealed yesterday that NHS Employers will not conduct UK-wide negotiations with the GPC, and will instead only negotiate terms for English GPs, as well as QOF terms for GPs in Wales. Entirely separate deals will be negotiated for Scottish and Northern Irish GPs.

Health secretary Jeremy Hunt mapped out the government´s plans for further GP contract revisions in a speech at the King´s Fund in London this week.

He said the GP contract will be rewritten by next April to ensure a ‘dramatic simplification’ in targets and incentives, with the aim of removing the ‘bureaucratic overlay’ from GPs’ work.

Additional funding will be channelled to general practice to help support GPs’ new responsibilities and will come from savings made by a reduction in unplanned admissions, he said.

The GPC has indicated a softer line towards Mr Hunt’s reforms since he vowed to tackle bureaucracy. Dr Vautrey said: ‘We´re looking forward to working with him and NHS England to address this in a serious manner and in the end, to give GPs more time with patients rather than box ticking and paperwork.’

The BMA findings follow an exclusive Pulse survey that found nearly half of GPs are jeopardising their mental health and are at a very high risk of burning out. Pulse´s survey of 1,800 GPs revealed that 43% of GPs are classified as being at a very high risk of developing burnout, with partners and those working in deprived areas particularly badly hit.

The Department of Health-commissioned national work-life survey carried out by researchers at the University of Manchester also showed this week that GPs are suffering the highest levels of stress recorded since 1998, with over half of those aged over 50 years saying they intend to quit direct patient care within five years.

Readers' comments (17)

  • BOX ticking when patients see you has become a pain. patients seem to have 2 or 3 problem they want to discuss. we need to take bp, ask smoking status ,advice smoking cessation ask for ED phq9 number 2 if due, etc etc. makes mockery of consultation for which he/she came to see you.. one need to collect all these data for qof while they are with us if you have any chance to hit the target.. we know not getting qof target will ruin practice finance. if this was not enough now cqc, new des, les etc and constant changes to destabilise practices.. every day there is a bad news for poor gp.

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  • Dear GMC
    If we are all on here saying we are working too hard or too much stress and unable to do the job properly, we are opening ourselves up to make a mistake because of the pressures. As we are aware of the situation does that qualify for wilful neglect?
    As we are unable to change things becasue we have to finance the practice via our contracts, we're shafted.
    Best Wishes and see you at my hearing.

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  • This may be too late for many of us. .

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  • Any new agreement must have a safeguard which prevents it being changed by one party after "consultation". Without this proviso it is simply an imposition of working practices and not a contract.

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  • I agree with 11:11 a contract must be firm and not easily alterable by the government as it suits them .

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  • Yes please ensure the contract is binding to both parties

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  • The DOH don't care how stressed everyone is. All Mr Hunt needs is votes so the only thing that will work is demonstrating how cuts to general practice through unworkable contract impositions will loose public confidence. Our best option is to make preparations to walk away from GMS and privatize general practice. The current contract is a dead duck.

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  • Vinci Ho

    A song to remind GPC the way we are treated:
    'Listen , we are alone at a crossroad
    We are not at home at our own home
    We have tried and tried
    to say what is on our mind
    You should have known
    Now we are done believing you
    You don't know what we are feeling
    We are more than what you made of us
    We followed the voice you think you gave to us
    But now we gotta find our own
    You should have listened......'

    Inspired from 'Listen' from Beyonce Knowles

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  • May I wish our new head of GPC every success in negotiations.

    Dr Buckman his predecessor was of the opinion that we were in an unwinnable situation in negotiations, because the government held all the aces (words to that effect).

    That may be true, particularly if the profession is never even asked to consider mass resignation and indeed if in that eventuality the threat of mass resignation turns out to be a damp squib.

    Nevertheless I believe many doctors including myself would be prepared to make that undertaking and, if there is any sort of sensible guidance from the BMA about how implement resignation, to act on that undertaking if the situation demands it so.

    Although many doctors will raise the financial risks of resignation, I would ask -- what future can GP partners look forward to if we are given an impossible workload, higher and higher quality standards to achieve, less and less resources, unable to recruit new partners even?

    Maybe that scenario is worse than the financial uncertainty attached to resignation?

    Please let's at least have the debate.

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  • Indeed GPC, you do us a disservice by not discussing leaving the NHS. If the dentists did, why can we not? Solicitors, Vets and any other number of professionals charge fees and survive. It is impossible to work in this NHS. I do not mind working hard, but I am killing myself filling in utter rubbish like co- morbidity forms. Have I to write a textbook for each patient. It has become bananas, Dr. Nagpaul. Or would you rather see you profession go to the wall. Send out a survey and actually see how many wish to stay in the NHS. Well, why don't you ?

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