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GPs go forth

Burnout puts Government's seven-day access plan at risk

Burnout poses a ‘significant’ risk of derailing the NHS efficiency drive and the move towards seven-day, a think-tank’s briefing to MPs said today.

The Nuffield Trust briefing – released ahead of a parliamentary debate on seven-day services today – says there needs to be a ‘step change’ in the way primary care services are delivered’, and says that ‘extended opening hours in a larger number of GP surgeries is.. a welcome aspiration’.

However, it highlights the ‘looming workforce crunch’ in general practice, caused by a ‘potential shortfall in GP numbers, real financial pressures and a growing primary care workload’, and says there must be change in this area.

The new Government has reiterated its ambition for a seven-day NHS, including primary care services, by 2020, despite widespread opposition from GPs.

The Nuffield Trust said it supported the Government’s aims, but added that ministers must address problems in the workforce first.

It stated: ‘Staff burnout is becoming a significant risk in many settings.

‘Politicians must think carefully about how to reconcile the need to develop and encourage the workforce with the inevitable political desire to maintain “grip” on the NHS when the financial situation continues to deteriorate. ‘

The briefing also said that there is a clear need to embrace change and extended opening hours in a larger number of GP surgeries is a ‘welcome aspiration’.

It said: ‘With general practice facing a looming workforce crunch caused by a potential shortfall in GP numbers, real financial pressures and a growing primary care workload, there is a clear need to embrace change.

‘Scaled-up general practice, better use of existing skills such as pharmacists or practice nurses, and developing innovative working arrangements with other health or social care providers in the area should all be pursued.’

Pulse recently launched its second major national survey of GP burnout. The original survey in 2013 revealed that almost half of GPs were at high risk of burnout.

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Readers' comments (15)

  • Sensible stuff, but will Cameron act on the advice? Yes there are possibly a few further efficiencies that could be delivered like more telephone consultations, not only in primary care, but secondary care outpatient clinics as well.

    The devil is that there are no brakes on demand. Without this things will still deteriorate.

    I wouldn't be surprised if the government brings in personal health budgets. For example X visits per patient per year, whether to primary or secondary care. After that you pay unless you have severe clinical conditions.

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  • 7 day working is so that corporations don't lose profit secondary to people taking time for appointments during the week . They can stump up the extra 40 Bn that would be needed for true seven day nhs operation.

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  • Ivan Benett

    Good report. It is true that in order to provide 7day Promary Care there will have to be a significant injection of resources, and very new ways of working. There will also need to be many more GPs and nurses.
    But it's the right thing to do. Let's embrace a seven day service.

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  • 7 day routine GP service is unnecessary, unaffordable and damaging. Fund out of hours properly for emergencies and stop trying to downgrade primary health care to a mere convenience

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  • Many GPs don't know what working 5 days a week means, and it will be hard for such GPs to be told to work for 7 days a week, therefore the Government should not introduce the 7 day access.

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  • Its ok for any one to say we need 7 day working, recruit the GPs but what about the other people that make the surgeries in Primary Care work? The nurses, the reception staff the cleaners etc?? Where are they going to appear from?

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  • Ivan why don't you just stop.
    Have some dignity man!

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  • I agree with Ivan provided we get another 55 Bn and 30.000 Gps no sweat.

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  • This is my letter to David Cameron:

    Dear Prime Minister

    In our society we are constantly reminded of effective management techniques, from parenting to team building, with the emphasis being on engaging the child/pupil/student/patient/citizen in the decison making process that concern him/her to achieve a better outcome, and this management technique is supported by highly regarded studies.
    However it seems that the highest management structure in the country, i.e the Government, is totally ignoring the civil servants it is trying to manage and dictating changes without any form of consultation.
    The BMA is representing the doctors of the U.K but its advice has been regularly ignored, as has been feedback from working doctors advising Government.

    Wouldn't it be more satisfactory to work with the doctors you are trying to manage rather than impose repetitively arbitrary rules based on imaginary patient’s demands, established by people who never interact with real life patients?
    Surgeries being open 7 days a week, 12 hours a day will not reduce patients admission to Hospital (more Community Matrons will certainly do) but will increase patient’s expectations and demands on the Health Service.
    Please do not treat us like Supermarkets as we do not provide tomatoes and beans, but valuable medical assessments which demand great responsibilities.

    When you will have demotivated all the profession ( and you certainly have been very successful at this over the last years), have not replaced GPs who are retiring early, and younger ones who have leaving the country or the profession, are left with unhappy and overworked GPs, will you have really increased patients satisfaction?

    I was contemplating leaving the profession a year ago but instead I resigned from my Partnership and am giving a final try as a Salaried GP.

    I love my job but if the constant governmental interference makes it as difficult as it is today, I will see no choice but to leave the NHS... As so many others doctors have done before me, and will do after me.

    Mr Cameron, please listens to us, ask our advice, take it on board. You will have much happier and better doctors, and at the end of the day a direct consequence of this: increased patient’s satisfaction.

    Thank you for your attention.

    Yours sincerely

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  • With Ivan, it all comes down to 1 word I think. Self-interest, as with bankers/politicians etc. Why else would he embrace more shite for the rest of the profession. there are NO resources, GPs, nurses or evidence that its good value for that matter, for this, so we're NOT going to embrace it. Enlighten us as to the reason why you're going in the face of the feeling that the rest of the profession has.

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