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Gold, incentives and meh

Burnout forces almost 10% of GPs to take time off work as pressure on occupational health services grows

Exclusive One in 11 GPs has taken time off work due to stress or burnout within the past 12 months, and as many as a third expect to do so within the coming year, according to a Pulse survey that lays bare for the first time the impact of GP burnout on the wider NHS.

It comes as the Practitioner Health Programme, the largest service in Europe for doctors with health concerns, revealed the number of new doctors and dentists seeking help has more than tripled in the past four years.

Asked whether stress or burnout was affecting their ability to work, some 9.3% of the 688 GP respondents to Pulse’s mutli-topic survey said they had had to take time off within the past 12 months. A further 32.5% said they had not taken time off but thought it was likely that they might need to in the coming year. The remaining 58.2% said they had not had to take time off work and did not expect to.

The findings comes as part of Pulse’s Battling Burnout campaign, which aims to raise awareness of the problem and lobby for better monitoring of GP workload and better occupational health support for those who need it. A separate Pulse assessment earlier in the year of almost 1,800 GPs using the validated Maslach Burnout Inventory tool found that 43% are classified as being at a very high risk of developing burnout, with partners and those working in deprived areas particularly badly hit. 

Professor Clare Gerada, the immediate past chair of the RCGP and new medical director of NHS London’s Practitioner Health Programme (PHP), said the programme was now supporting between nine and 11 new doctors or dentists each week, compared with around three new practitioners a week four years ago.

Professor Gerada told Pulse: ‘The two groups we have most contact with are GPs and A&E doctors. The increase is partly because more people know about us, but there is certainly an increase in illness levels as well. The word burnout is used to describe this but I don’t like the term, because it’s actually depression given a more acceptable label.’

She said a number of factors were to blame for doctors’ plummeting morale over the past year.

‘Change always produces anxiety, but we are also seeing the denigration of NHS staff in the media, where we are being blamed even though most of us are trying to do a good job,’ she said. ‘It feels like GPs are seen as both scapegoats and messiahs. People want us to save the NHS through commissioning, but they also blame us for the problems.

‘My message would be to hang in there, because things can only get better.’

Today’s findings follow a GPC survey published in September, in which a huge majority of GPs reported they were battling excessive bureaucracy, facing a shortage of resources and suffering from low morale. Some 94% of GPs said they had experienced an increased workload since the imposition of the 2013 GP contract in April.

GPC deputy chair Dr Richard Vautrey said that the 40% reduction in QOF points agreed for the 2014 GP contract was a ‘step in the right direction’ in reducing GPs’ stress levels, but added: ‘Nobody should be under the misapprehension that this will make a major difference. Most of all we need additional resources so that we can take on more GPs and nurses to meet the patient demand.’

Survey findings in full

Have you had to take any time off work for stress or burnout within the past 12 months?

Total number of respondents: 688 GPs

No, and I do not expect to: 400 (58.2%)

No, but I think it is likely I may need to in the next 12 months: 224 (32.5%)

Yes: 64 (9.3%)

About the survey

Pulse launched this survey of readers on 15 October, collating responses using the SurveyMonkey tool. The 26 questions asked covered a wide range of GP topics, to avoid selection bias on any one issue. The survey was advertised to readers via our website and email newsletters, with a prize draw for a Samsung Tab 2 tablet as an incentive to complete the survey.

As part of the survey, respondents were asked to specify their job title. A small number of non-GPs were screened out to analyse the results for this question. GPs were also asked on a voluntary basis to provide their GMC number and the majority did so, although these were not verified or used to screen out respondents.




Readers' comments (38)

  • We do not get compensated well at all. You have no clue about primary care do you!

    I'll take out the fees to make it comparable to hospital colleagues. My gross (i.e before tax is taken out) hourly rate as a GP partner in average earning practice after employer's pension contribution and indemnity fees and course fee taken out is £30/hour. Bearing in mind I'm an employer with all the risks of an employer (which hospital consultant do not have), this is poor pay. Try and find a consultant happy to work for even double our hourly rate - you won't find one.

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  • my practice was in danger of being swamped by new registrations I had a higher average list than those around before you counted their Salaried locum Nurse practitiones and trainees etc. I applied to close the list, local practices contacted only 2 bothered to reply and they were quite happy for us to close, and the LAT said no. I am fine but do I have to keep going until I collapse? We have to be in charge of our workload.

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  • Can you not decide on a list size and then decline new registrations until you get to your target ?

    As long as you have reasonable grounds to turn people away i.e. not enough staff, and reject with no discrimination, then surely you can decline and reassess registrations on a daily basis.

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  • >the LAT said no

    That's crazy. You should write back advising them that if the list keeps increasing you won't be able to guarantee appointments or safety and ask for the name of the person stopping you. Let them know you will hold them responsible for anything that occurs.

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  • The 'if you can't stand the heat get out of the kitchen argument' is rubbish, and propagated by those who fail to fully engage with patients and therefore never experience the full stress of caring. Politicians have never understood this and it is sad that some of our colleagues don't either. There are some aspects of a G.P.s job which cannot be compared to other professions, we can start with the care of the terminally ill.

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  • These figures do not include those of us who are getting out BEFORE we become ill with burnout. With a heavy heart from leaving a job I love, but with a huge sense of relief, I have 4 weeks to go before leaving GP partnership. I have been inundated with letters and conversations with my patients expressing thanks for my care and regrets at losing the continuity and personal care I have provided, but every single one of them has said they understand why I am leaving. The Secretary of State has just announced a new Contract "to bring back old-fashioned GPs". Its a shame he hasn't made more effort to keep the ones he already has/had!

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  • One of our youngest partner called in sick earlier this year. Just couldn't take the work load anymore and has since left the partnership. We now have only one partner that was here 4 years ago - rest has retired. I can only hope our newest recruit can take the pressure

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  • Sooner or later, every healthcare organization must realize the math of providing healthcare. The foundation of patient satisfaction and quality care is the health and life balance of the providers - physicians and nurses. If you simply treat them as wheelbarrows into which you load more and more tasks and responsibility ... they will burn out. You can't give what you haven't got. You can't be compassionate or even patient when you are burned out. There has to be a balance struck between work and the provider's personal health and well being. Without this balance you get mediocre care, and burnout.

    Dike Drummond MD

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  • Dike Drummond MD

    well said and I completely agree !

    unfortunately our leadership and 'representative' bodies couldn't give a **** about us. We have been abandoned and are left with making our own individual career decisions. It is hard to support our patients when we receive no support our selves. At this point I'd rather scrap the NHS and start from scratch!

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  • Being A GP has become very stressful, if it was just demanding none of the GP,s would have complained but as the volume of workload is increasing, incentives are disappearing, GP are being blamed left right and centre for things which happen and both do not happen. It is like GP are expected to know the problem like a specialist, be nice like a GP, keep the referrals and costs as low as possible. I am getting confused who are we responsible towards The Patient or the Goverment?
    We are certainly asked not to prescribe this, not to refer for this, not to send to AE, not allowed to do certain things ourselves?????
    Is is just the GP's who get treated like a doormat?

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