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At the heart of general practice since 1960

Analysis: General practice is starting to crack

Even experienced GPs are under enormous pressure as the NHS piles on yet more demands, writes Devon LMC chair Dr Mark Sanford-Wood

It is widely known in management circles that organisational change brings with it uncertainty and threat, and that this has the potential to generate illness, stress and absence from work. Successful management understands this and works hard to show leadership, to reassure, and to paint the vision that people can believe in and follow.

Even the most ardent enthusiast of the NHS reforms could not be self-deceiving enough to claim that this is a description of the management style we are experiencing at present.

In the last two years GPs have been told they will become responsible through CCGs for all the NHS funding problems and shortfalls. They have seen consultation rates rise inexorably, the anxiety of CQC inspection, and the worry of revalidation. Income has fallen and complaints, GMC referrals and threats of legal action have grown.

On top of this pensions have been severely downgraded and the profession now faces a draconian attack upon its income in the form of the Government’s contract imposition.

Whether it is good management technique to heap this perfect storm on a beleaguered profession just as you ask it to steer the ship is an interesting question. However, the effects on morale and health are plain to see.

The results of the survey of GP workload by LMCs across the South West made for chilling reading - and the survey was conducted in the first place because LMCs are experiencing a dramatic rise in calls for help.

Devon LMC has seen a doubling of new referrals in 2012 compared to 2011 and other LMCs have witnessed a similar upward trend.

There is a human cost in terms of lives shattered and careers blighted. And the particularly worrying development not fully apparent in those statistics is the fact that experienced veterans - the heart of our profession who have always stood firm - are now calling for help.

The solid yeomanry of general practice is starting to crack, and when that happens everyone should fear for the future of the NHS.

Dr Mark Sanford-Wood is executive chairman of Devon LMC

Readers' comments (13)

  • Good points, but no mention here of the extra pressures on all English practices also about to impact via the arrival of the CQC from April 1st . A range of extra forms will then need by law to be submitted to CQC within 28 days in the event of not-uncommon occurrences in practice (e.g. abuse/suspected abuse, incidents involving the police, unexpected patient deaths, short-term closures, changes to GP Partnerships, absence of the CQC Registered Manager, etc).

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  • This comment has been moderated

  • Looks like Richard above has something to sell :)

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  • Bail out! Bail out! We're going down in flames.

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  • the appraisers amongst us know the scale of the real problem and it is very dire indeed .

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  • We in Wales have secured slightly better deal with contract than English counterparts However, recruitment staff into GP here abysmal and virtually no applicants for any job! Morale at all time low GP's under Enourmous pressures and as study's show more and more GPs seeking'pastoral care' in other words burnt out, stressed out and depressed!
    Now here one of major local DGH's closed to diabetic and endrocinology patients as no staff!!
    Writing on the wall When will politicians wake up and see mess NHS in and stop vilifying those that worked so hard to maintain service and acknowledge all at breaking point!! If I could would retire t'morrow as so demoralised by whole shambles

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  • Thanks PULSE for doing differently from others. You are a leading source highlighting doctors' problems in the UK. And also by giving voice to the oppressed minorities and Immigrant doctors you are doing what is needed from a leading news journal.
    "A nation's greatness is measured by how it treats its weakest members."-Mahatma Gandhi

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  • Is there health and safety for doctors ? I have done 168 hour weeks with very little sleep often and 80 hour weekends with 4 to 8 hours sleep routinely. At the end of the day, we are masters of our own destiny to a degree and the fault is not in our stars. The BMA could define safety levels like for airline pilots and lorry drivers as a start. or
    It is time to resign from the NHS. Doctors cannot be done without, Private medical care is hugely expensive, but £ 2 - £3 take home pay per consultation is not enough for the years of study.
    We have to leave for our sanity.

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  • Anonymous 30th Jan can presumably bend space and time. There are only 168 hours in a whole week so working this many hours would leave zero time for sleep. And there’s only 48 hours in a weekend - where did the other 32 come from?

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  • The weekends on call were Friday 0900 to Monday 1700 that is how it gets to be 80 hours

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  • I think anonymous means Friday 9 am to Monday 5pm. !68 hours was routine ie no break at all. If you worked 1;2 rotas and your colleague went on leave you were on call till he came back. I have done 3 months of continuous duty without a break because my colleague was ill.

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