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GP workload 'unsustainable' and should be managed, say researchers

GP workload should be managed by reducing bureaucracy in the short-term while capacity issues are being resolved, UK researchers have proposed.

This comes as GPs feel a full-time career as a GP partner is ‘unsustainable’ due to workload pressures, with many planning early retirement in response.

The University of Oxford researchers looked at perceptions of workload, as well as the strategies that GPs employ to cope with workload.

The studies, published in the BJGP and based on interviews with 34 GPs in June and July 2015, found that GPs were struggling with 'increased patient needs and expectations'; 'more work coming into primary care from secondary care'; and 'increased bureaucracy'.

The participants were chosen out of 171 respondents to an advertisement in order to maximum variation between them and researchers carried out an in-depth interview with them on a variety of topics.

The researchers found that ‘nearly all participants’ felt a full-time career as a GP partner was ‘unsustainable’, with many planning early retirement or knowing colleagues who had done so.

Typical working days of respondents were 10-14 hours long, with partners having long days than salaried or locum GPs and many participants saying they had to do admin outside of work hours.

Researchers also found that GPs felt continuity of care was ‘integral to general practice' but being eroded by ‘changes in contracts and working patterns to deal with workload’.

As for how GPs cope with the pressure, the concluded that GPS demonstrated 'an encouraging resilience' to the pressures, but said that 'GPs do not feel they can do this alone’.

Participating GPs said that working part-time or having a portfolio career was an important method of managing workload.

The researchers suggested that a number of things needed to happen to relieve pressures and enable GPs to have sustainable full-time roles.

This included patients self-managing more (although 'GPs should not be responsible for this education') and more staff being recruited into general practice.

The authors concluded that the ‘study highlights the urgent need to address perceived lack of investment and clinical capacity in general practice’ and that managing patient expectations and reducing bureaucracy are key ‘at least until capacity issues are resolved'.

They also warned that 'the unattractiveness of partnership is particularly worrying because these positions are mainly occupied by the most experienced GPs who are in the best position to be able to retire'.

There were some limitations in this study, such as the small sample size and the possibility of self-selection, the added.

The study comes as GP leaders in England have in the past called for the Government to halt CQC inspections to reduce pressure on GPs.

It also comes as the Welsh Government announced today that it will pause QOF reporting due to workload pressures.

A recent Pulse survey of 1,200 GPs found that a quarter work beyond safe limits on working hours every week.

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