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GPs go forth

Revealed: The rising tide of GP burnout as NHS cuts support

Exclusive Rising numbers of GPs are so stressed during their working day that they are at a high risk of burning out completely, reveals the largest ever survey conducted in the profession.

The Pulse survey of 2,230 UK GPs shows 50% are at high risk of burnout, up four percentage points from the same survey two years ago.

GP leaders say the health service has become an ‘industrial hazard’ and that burnout is forcing more GPs to leave the profession.

But the few occupational health schemes providing support to struggling GPs in England have had their funding cut and in Scotland NHS managers are looking at charging for their services.

The Pulse survey shows that three-quarters of GPs feel emotionally exhausted while 25% report a low sense of personal accomplishment.

Dr Daniel Mounce, a former GP in Bradford, left the profession ‘after falling apart mid-consultation’.

He said: ‘For me, leaving general practice has been like leaving an abusive relationship. The shaming and invective, the fear, the unreasonable demands were about driving down self-esteem. I can’t quite believe I ever thought I could stick it for another 30 years.’

Doncaster GP Dr Shahzad Arif, who was recently slapped with a breach notice by NHS managers after burnout forced him take sick leave, told Pulse he was ‘frustrated’ at the total absence of support.

He said: ‘I think it was perhaps something waiting to happen; there was a slight trigger that day because the practice had been unusually busy and I decided I need a break, I couldn’t go on.’

June 2015 issue cover story - GP burnout infographic 460x368

In response to the first burnout survey, Pulse launched its Battling Burnout campaign that last year won a pledge to fund occupational health support for all GPs in England.

But NHS England has yet to release the long-overdue service specifications, and in the meantime has slashed funding for previously excellent mental health support services in Devon, leaving GPs to resort to self-funding.

In Lancashire and Cumbria, LMC chief executive Peter Higgins said that NHS England scrapped the previously ‘very good’ services in 2013, and it has so far refused bids from the LMC to have mental health service put in place.

In Kent, LMC medical secretary Dr John Allingham said: ‘We are hanging on by the skin of our teeth. We have occupational health funding for next year, but nothing guaranteed going forwards.’

It is the same case in Lothian, where GPC executive member Dr Dean Marshall tells Pulse there was a counselling service and occupational health ‘but now they’re talking about charging GPs for it’.

Former RCGP chair Professor Clare Gerada, medical director of a confidential mental health service for doctors in London – said: ‘The NHS at the moment is an industrial hazard, and especially for GPs. Of course we go beyond the call of duty, but to do so every single day is causing great harm to GPs.’

Professor Gerada said her service - the Practitioner Health Programme - had been forced to shut its doors for six weeks in March after a ‘massive increase’ in demand, most of it from GPs.

It comes as the Government plans to roll out seven-day working for GP practices and NHS England’s Five Year Forward view plans for GPs to take on more care outside hospitals. The health secretary promised GPs a ‘new deal’ that will be announced this month to ‘look at why GPs have so much burnout’.

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Readers' comments (102)

  • I only do 6 clinical sessions a week
    Which means I only work 3 days
    But I feel burnt out.
    What should I do?


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  • As a mere manager, let's please not forget other practice staff who are equally struggling – Nurses who may need to absorb GP work, HCA picking up Nurses work, Reception staff who are being shouted at by all and sundry, squeezing appointments in where there is none left, PMs who desperately trying to juggle finances, tempers from all staff mentioned below, conjuring Locum GPs and Nurses out of the thin air for meagre hourly rate (remember – juggling the money) AND at the drop of a hat, endlessly trying to recruiting disillusioned Partners, Salaried, don’t even mention recruiting Nurse, etc…. So, let us look at the whole picture and do something that is good for all. And if that is saying a loud and clear NO! Jeremy Hunt, let’s do it. And this time let us do it right.

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  • Unfortunately it seems GPs are waiting for someone to rescue them as evidenced by constant appeals to the public or politicians. Perhaps understandable as we spend our days "rescuing" or helping others. Until we realise that we are only going to be rescued by our own action we are doomed. If we wish to preserve good quality medicine (either via the NHS or a European type insurance scheme) and ensure we have talented professionals working in healthcare in the UK we may have to brave the wrath of politicians and the public by making a stand. Sadly I'm not holding my breath...

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  • Una coales is right!
    As a Generation Y doctor as we are apparently known, I refuse to trust our politicians, leadership and those that call the shots on my behalf.

    That's why I resigned my GP partnership and took my MB ChB & MRCGP abroad with me to greener pastures!!

    Who calls the shots now??? I do! If I get burnout down under its because I've been out in the sunshine too long!! Thank god my skills and education actually count for something again.

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  • Yes but isn't it interesting how many of these poor 'burnt out' doctors spend their two days off after slaving for six sessions in their practice earning extra cash at the CCG, tearing apart their local DGH and setting up businesses to tender for additional work - with the contracts handed to them by their mates at the CCG. Overworked indeed...

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  • For all practices NHS is our employer (despite GPs being self employed). As we have a duty of care to our employees, NHS England as our employer has a duty of care' to the employees- that's us, and not only to those managers sitting in the high office thinking about how much slave labour they can exploit from GP workforce.
    I would also like to ask GPs working in NHS offices why once you enter in that office start behaving like a tyrant?

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  • Knowledge is Porridge

    Thank you Clare Gerada for speaking your mind. The more controversial you get, the more I agree - so please continue speaking out.

    I think you were spot on when you spoke about GP's becoming salaried a couple of years back. You were describing the solution to many of the complaints of struggling GP's today, but many mistook it as a threat.

    I suspect you have seen with your own eyes the benefits of a large GP organisation, which is properly led and supports its staff. Many of us don't want the responsibility of worrying about the building, the contract, the QOF, CQC, every complaint or "significant event", looming retirements and recruitment and the rest.

    We have seen dental practices joining larger organisations which can deliver effective support to individual practices, leaving the dentists to be dentists. We are also seeing larger GP organisations taking control of budgets and taking advantage of forward looking pots of money to redesign. Your Hurley group has dreamt up the webgp thing, such a simple idea. (of course we don't just need a webGP type system for patients accessing GP, we need another to support GP's accessing secondary care)

    But while I am keen to jump into a john-lewis mega GP organisation, some in my area are not ready.
    And those who are ready, haven't got the time to do it.
    And those who are ready, and make the time, hit big salary variations.
    So for all the talk, there is little action.

    At least it feels like we are doing something...slowly

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  • The Government wants us all to resign.

    No Government will ever change the NHS from unlimited consultations at the point of access. That is why they are deliberately encouraging demand for access.

    So if and when we resign and change the system to co-payment the Government of the day will not be blamed by the voters

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  • So we need to resign as soon as possible before GP becomes even more intolerable

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  • There are a number of online sites that we could use to send out a mass resignation letter. Just Google online petition or online resignation letter.

    Hamish Meldrum did this in 2001, but I don't think our current BMA representatives will do it, for whatever reason.

    The online letter would be automatically sent out to all GPs' NHS email addresses. It can also be optimised for social network sites such as Facebook and Twitter. Pulse Magazine could also help.

    The letter of resignation would go along the lines of stating what GPs would do e.g. Number of consultations per year per patient for the £126. Consultations over and above this limit would be charged directly to patients. The letter also should outline the proposal to develop our own private health insurance package that could be set up using any number of insurance companies.

    I'm afraid I'm too tired and worn out to do this myself, besides I shall shortly be retiring anyway

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