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At the heart of general practice since 1960

'Shocking' numbers of GPs seeking pastoral support, say LMCs

Exclusive Spiralling practice workload has led to ‘shocking’ numbers of GPs who require pastoral help as many struggle to cope with stress and mental health issues, LMC leaders have claimed.

Figures from one LMC show a four-fold increase in the numbers of GPs presenting to pastoral care services in the first half of 2012 compared to the same period in 2011, and a doubling of the numbers overall.

The Cameron Fund, a charity that provides financial support to GPs suffering ill health, disability, death or loss of employment, has also witnessed a rise in applications. The charity received 265 requests from GPs or their dependents in 2011 and 2012, compared with 121 requests in 2010 and 2009.

The concerns come after an LMC-run survey of some 2,700 GPs across the South West found half were considering quitting general practice and two-thirds believed their practice would struggle to remain viable due to the Government’s planned contract changes. Last year a major study published in BMJ Open suggested almost half of GPs assessed using the validated Maslach Burnout Inventory tool fitted the criteria for ‘emotional exhaustion’.

LMC leaders said they feared the additional work set to be included in the new GP contract from April would make the problems worse.

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In Devon, 33 GPs presented to the LMC’s pastoral care services in 2012, compared with 17 in 2011. Dr Mark Sanford-Wood, executive chair of Devon LMC, said he had witnessed an ‘enormous rise’ in requests for help, advice and support from GPs, in particular from partners suffering with stress and burnout, and alcohol and drug abuse.

He said: ‘This is quite shocking. The Government have to realise their changes have very real effects on GPs.’

Dr Robert Morley, executive secretary of Birmingham LMC said: ‘Pressure from CQC [registration], revalidation, sweeping contract changes, years of a pay freeze, rising expenses and spiralling workload are the reasons for this.’

‘It will only get worse as patients’ demands and expectations are fuelled by cynical and self-serving politicians at the same time as the contract imposition slashes practice resources and the CCG agenda gives GPs statutory responsibility for rationing,’ he added.

Dr Nigel Watson, chief executive of Wessex LMCs, said that there had been a 100% increase in GPs presenting at the LMC’s pastoral care services this year compared to last.

He said: ‘There’s workload saturation already. GPs are thinking about retiring, going abroad and then there’s increased pressure on the remaining workforce. Some practices are just not getting suitable applicants for jobs.’

‘It’s definitely going to get worse. All the factors contributing - ageing population, chronic and long term disease management, increased workload and lack of investment - will mean GPs will just work harder to do what they have to do. It’ll put them under a lot of pressure which will affect their health.’

Dr Peter Graves, chief executive of Bedfordshire and Hertfordshire LMC, said he was so shocked by the increasing need for pastoral care that he was petitioning NHS managers locally to set up a specific support service for GPs.

He said: ‘For about 15 months now I have seen an unprecedented number of GPs presenting for pastoral care for unacceptable levels of stress, right up to full-blown serious mental illness. I have been struck with not only the numbers but also the severity.’

‘It has resulted in me putting papers to the PCTs and CCGs to propose that we set up a Practitioner Health Programme similar to that in London. I will be pursuing this relentlessly.’

Dr Beth McCarron-Nash, a GPC member, former GPC negotiator and GP in St Columb Major in Cornwall, said: ‘The perfect storm we’re entering means GPs want to retire, and vacancy rates are rocketing. A GP being stressed will obviously have an effect on patients.’

‘On top of this a lack of investment has meant many GPs cannot take on more partners to share the burden.’

Readers' comments (17)

  • (1) you really think politicians care about this?
    (2) We need to look after ourselves as a profession .
    (3) the public needs to be educated more to understand the difficulties we are having

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  • The politicians do care. They are delighted as this is what is actually being planned. GPs getting to a state in which they must leave either to protect themselves or because their health has already given up is exactly what they want. Do not think that this is accidental.

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  • Oh and don't forget that there is a mechanism for claiming damages from the NHS if something related to your work has damaged your health. This needs to be more widely publicised and tested, in court if necessary. It is for the benefit of GPs as well as employed staff.

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  • Vinci Ho

    Editor
    This commentary box is not registering names even you have locked on
    Vinci Ho

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  • Vinci Ho

    The first comment was mine

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  • Peter Swinyard

    At the Family Doctor Association we are also having many more members ring for pastoral support. The stresses we are all under as GPs are unprecedented in the 28 years I have been a principal. The pips are squeaking. The younger will emigrate and the older retire earlier than they intended. So who will still be there to look after our generation in our old age? And please please please don't say that physicians assistants will do it all with a cohort of nurses to support them, running to protocols.

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  • i am young GP partner and now lost any hope in continuing working in NHS. Looking to emigrate as you earn almost twice elsewhere in the world with a lot more respect and recognition, not treated like trash - the way we are at this point. I agree there is going to a lot of good talent lost to other countries which will never come back

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  • What can I say? I have been a partner since 1985 and am retiring in May. I have a calender ... so that I can strike out each remaining day. It's wonderful!
    The sad thing is that I still love seeing patients. Oddly I loved the job for my first 20 years, tolerated the next five years and just about survived since then. It has gone from a job I adored to one that I cannot wait to leave.
    The first twenty years were not everyone's cup of tea. We were on call 1/4. We ran two small hospital for precious little pay. We ran a 24 hour casualty. We covered our own intra-partum obstetrics. (By the way for a delivery we were paid the same money as for removing a coil!!) But we were in charge. We could look after our patients in an individual manner that brought this doctor at least profound pleasure. I also felt I could tailor treatment to the individual. Together we could choose the Consultant that would suit them best. I had a personal relationship with each patient on my list.
    Now we do not do on call. We have farmed out our hospital work to assistants. I spend my life looking at screens rather than patients. It may suit some but to me it is a poor pretence at real medicine.
    The sad thing is I have a bright 14 year old son keen on Medicine. I have to reassure him that Medicine is a wonderful career. Probably not in the NHS though. It can still give immense satisfaction. My disillusion is not with the Honorable Profession itself but for the National Health SYSTEM I now find myself working for. An irony as for all its failures before 1990 it was none the less a system that I would have thought I would support to my dying day.
    I go in May. I cant wait. Six years earlier than planned. To my surprise and I suppose relief I will walk through the door on my last day with never a backward glance. I will be sad to leave colleagues and loyal staff but that is all.
    As regards my son I would advise him to work abroad. I certainly would.

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  • /Anonymous 7.14pm I agree with all your sentiments. I also became a partner in 1985 and like you felt in control and with happier patients. We are now driven by rules that are beyond belief. Like you I really enjoyed looking after patients but now we have barriers put infront of us which take all our time away from patient care-the government just does not see it. With no pay rise and overwork no doubt more GPs are thinking like us.

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  • It isn't any better for the loyal staff and managers that support the GPs - Please do not forget them as they endeavour to keep up to speed with the change - the new Health ans Social Care bill could well be the death knoll for Family centred NHS

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