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Gold, incentives and meh

Most GPs ‘drowning in work’, says NICE chair

GPs are ‘drowning’ in work and the Government needs to listen to their concerns that patient demand is unsustainable, the chair of NICE has told delegates at Pulse Live.

Taking the stage for an interview with Pulse editor Nigel Praities, Professor David Haslam said most GPs he knew were struggling with their workloads as demand in general practice continued to rise without any additional funding to match it.

Professor Haslam said: ‘I know most of the GPs I meet are struggling, they are drowning in work and the constant never ending demand and the feeling they can never get on top of it.’

He added: ‘We have to find a way of supporting them as well as ensuring GPs get the best quality care.’

Professor Haslam said the narrative on what patients could realistically expect from general practice needed to change and criticised newspapers for voicing patients’ concerns over access without also explaining the pressures GPs are facing.

He said: ‘It drives me absolutely mad when I see newspapers criticising GPs for access issues - which are a real problem for patients without accepting the reason why access is poor is their doctors are already working 12 hours a day and struggling. It’s not that they’re twiddling their thumbs and counting the vast amount of money some newspapers claim they are making.’

But he said this narrative could change with GP leaders such as GPC chair Dr Chaand Nagpaul and RCGP chair Dr Maureen Baker fighting GPs’ corner – and said he believed the health secretary, Jeremy Hunt, also understood the problem.

Professor Haslam added: ‘There is a great need for more [secondary care] generalists working in partnership with GPs in the community.’

‘If we can bring these together we will have far more resources in the right place, but at the moment secondary care sucks up so much – and primary care just gets told, “the secret is to get everything out of hospital into primary care”, while simultaneously the budget just doesn’t match it.’

In an earlier session Professor Haslam told delegates NICE recognised the specific challenges GPs face and was fully committed to making guidance more relevant to their daily practice, managing complex patients.

Professor Haslam said: ‘What I know for certain is taking the NICE guidelines for each [single] condition and adding them together is no way to deliver quality care for that person.’

‘It’s absolutely clear we have to find a way of addressing the whole complex issue of multimorbidity and that’s something NICE is absolutely up for.’

Readers' comments (26)

  • Anon 8:23am: '...these days the partners' drawings are not all that significantly above those of salaried docs......' It is my understanding that Partners earn considerably more than salaried GP's.

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  • Bob Hodges

    " It is my understanding that Partners earn considerably more than salaried GP's."

    I think your understanding might be wrong Neil. There's not much in it in terms of take home, andwhen hours are considered it's often less per hour. I'm ivolved in locality commissioning and LMC so get to looks at this in detail.

    Certainly when I became a partner, the £500 per month increase in taxable pay was more than overshadowed by the increase in hours that I worked as a result.

    Since then, my drawings have reduced and my workload increased further. I'm now earning less than I did as a salaried docotr, and my hours are 25-33% longer.

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  • Spencer Nicholson

    all just more reassuring that I escaped when I did sounds like a real s**tfest

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  • No, partners do not earn considerably more than salaried per hour and as a consequence we prefer to recruit partners. Your gross drawings at first appear substantially higher but you pay your own employers national insurance and have to ''buy in' which wipes out a lot of the difference. The personal risk legally and financially is much higher, the workload more intensive and the hours are longer. On the plus side partners have slightly more control over their working lives and how the practice runs but many GPs are being squeezed so hard that the current model is at risk of failure with grave consequences to patients. I very much doubt that the private providers will be the shining white nights in armour riding out to rescue the NHS as some politicians and commentators believe.

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  • Took Early Retirement

    Strange, innit? Everyone realizes there is a crisis except the SOS for Health. (and the Daily Wail)

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  • Dr Mustapha Tahir

    I'm certain Mr Hunt knows the difficulties GPs face daily, but he has a strange way of showing he understands.

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  • dear 10.49;
    ''Since then, my drawings have reduced and my workload increased further. I'm now earning less than I did as a salaried doctor, and my hours are 25-33% longer.'' if this is true and the same is true for your partners ....and you still are staying as partners in a GP business...then I am sorry but you deserve the crap thrown by the govt at you. You all need to dissolve the practice and become locum /salaried.

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  • If you dissolve the partnership the liabilities are likely to bankrupt the incumbents. You may be down on income but who wants to lose their capital ?

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  • Well said, Prof Haslam. Please now say the same thing to the media who are poisoning public perception of GPs. Not a day goes by without me hearing a patient mutter that we are overpaid and only work a few hours per day. After all, if we aren't actually seeing patients, we are twiddling our thumbs/out to lunch/playing golf, as we don't have anything else to do, right? And how dare we have time off for training, holiday, illness, maternity, etc? Until the mass media actually educate the public, this is an 'us against them' battle which we are losing. Public expectation is utterly ridiculous: see their own designated doctor 7 days per week, night and day? Are wee now robots who don't need to eat or sleep, or have a family life? In addition, patients are coming to see GPs every day with utterly minor ailments; coughs, colds, tummy bugs, which a few years ago people seemed to have the common sense to self manage. If a patient expects to be seen as an emergency for every sniffle, then there really is no hope of sustaining GP.

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  • You guys need to prioritise your problems and deal with one issue at a time. One concerted campaign at a time. Do you not have a PR agency? When's the last time you ran a nationwide campaign? Oh and please don't give up your practices to corporations- you'll be asked to perform an impossible commercial/professional balance and generally have all the benefits you've worked so hard for eroded.

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