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Workload survey: GPs can shout about workload all we like, but we need evidence

Professor Helen Stokes-Lampard

Dr Helen Stokes-Lampard – 3x2 – online

Dr Helen Stokes-Lampard – 3x2 – online

Our profession is ‘the bedrock of the NHS’. Those aren’t my words - although I have repeated them many a time.

Those are words straight out of the mouth of England’s health secretary, Matt Hancock.

Yet, we’re facing a tough time in general practice.

A 12-hour shift is now commonplace - in a recent day on-call in my own practice, I had more than 100 patient contacts when you take into account face-to-face and phone, and helping out colleagues in training with support and second opinions.

Our workload has become relentless, and as a result we’re seeing excellent, hard-working GPs – as well as other members of our practice team – burning out with the pressure, right around the UK.

Unlike hospitals, we don’t have the daily data showing our precise workload rising exponentially

We need more GPs. NHS England and Health Education England are doing a good job at boosting GP recruitment, and we now have more GPs in training than ever before, but we also need to do everything we can to keep our experienced and talented existing GPs in the profession.

Our workload needs to be addressed. It rose at least 16% over seven years – both in volume and complexity – according to research published in 2016.

And we spend way too much time dealing with time-consuming admin and bureaucracy, which is taking us away from frontline patient care.

That is one crux of the matter: unlike hospitals, we don’t have the daily data showing our precise workload rising exponentially on an annual basis. We can shout about it all we like, but decision-makers want to see the hard evidence.

Pulse’s survey will give a snapshot of the workload we’re facing in general practice right now and I’d encourage GPs to take part.

We are also now starting to get monthly data from NHS Digital about GP consultations, and the RCGP’s own Research and Surveillance Centre is embarking on an exciting project – a workload observatory – so that we will have the data that can authoritatively influence planning decisions at the highest level in future.

We’re still recruiting practices to take part in our workload observatory, so if you’re interested in signing up your practice, there is more information here.

NHS England's long-term plan has some great aspirations that promise to benefit patients – and recognise the importance of GPs and our wider teams in ensuring the sustainability of the NHS for years to come.

But delivering the plan will need the comprehensive workforce challenges we currently face to be addressed.

We need the forthcoming workforce strategy to explore all possible options - and tackling workload to make the profession more attractive for future GPs, and more tenable for existing GPs, will be key.

Professor Helen Stokes-Lampard is RCGP chair

Readers' comments (14)

  • Council of Despair

    what I love about the RCGP is that they are great are describing the sky as blue and the grass as green BUT what has the RCGP actually done for grassroots GPs in the last 10 years? Can anyone explain the point of RCGP's existence? I mean if the RCGP disappeared overnight would it make any difference to our day-to-day work? I don't want to be harsh but most colleagues I know just laugh and ignore the RCGP as it just seems to be a historic legacy of a time when GPs were taken seriously. And let's be serious whatever the state comes up with you KNOW the RCGP will back it! So I don't see the point of whatever comes out of the RCGP - it's just a distraction.

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  • Vinci Ho

    ‘We need more GPs. NHS England and Health Education England are doing a good job at boosting GP recruitment, and we now have more GPs in training than ever before, but we also need to do everything we can to keep our experienced and talented existing GPs in the profession.’

    I will be very careful how one would use the words ‘good job’ , Helen . As a Royal College , it should define its political position as far as facing politicians and technocrats are concerned . I can understand that you need to work and negotiate with them , but clearly not ‘get into bed’with them . It is the ‘crime’ of politicians who have created this hostile environment for GPs and hence , it is their responsibility to bear the consequences and sort out this mess. Always remember who our common enemy is .

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  • The RCGP has not only ‘got into bed’ with our scourgers but has also consented to disagreeable activity from those parties, which consent has unfortunately and incorrectly been extrapolated to the rest of the profession.

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  • Surely the RCGP could have funded this piece of work?
    I would see that as their core function. Not leaving it to a magazine.

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  • The RCGP should have done this decades ago.They have sat on their hands, collaborated with government.Why have the not defined a safe workload for individual GPs.Why do they do research on the text book symptoms of laryngeal ca pathway and referals which we all know.They have been part of the problem ,and the establishment, for too long and choose to ignore the real issues as does the GMC and our ineffectual union(it will be interesting seeing the BMAs membership numbers this year).They are all acting too late, within 5 years at this rate the majority of the 1995 pension scheme members will be out never to be replaced.A decade of inaction means even a 2004 moment will not alter most of our plans.To Little,to late.Pulse has been our only beacon in these dark times,our only source of truth and sanity.God bless this magazine and our front-line colleagues.Shame on the rest of you.

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  • Abolishing the RCGP would be a significant step in the right direction.

    As for surveys, that tried and tested tool worked really well for the BMA......Not.

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  • Pinky and Perky.
    'We need more GPs'.
    Well, I never.

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  • A survey is a technique for looking concerned whilst having no intent to do anything useful, it's prevarication, a fob off. The BMA love surveys, did they ever help?

    A few simple things the RCGP could call for that would help:
    - Abolish Appraisal and Revalidation, save millions, return appraisers to useful work, and free up the equivalent of hundreds of wte GPs.
    - A minimum charge for appointments; look what a 5p charge did to plastic bag use.
    - Reverse pension and tax changes that punish doctors for working.
    - Scale back, preferably abolish the CQC. Sacking Dolores Umbridge would instantly improve morale and dramatically reduce the pointless bureaucracy inflicted on GPs.

    Or we could just have another survey, that will help, definitely, and perhaps some colouring books too.

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  • Bob Hodges

    Gentle moving back on topic.....

    The absence of 'data' about GP activity has indeed been our downfall. As thousands of small practices all using different computer systems and appointment books in different ways, it not just been trying to compare apples with oranges....it's been fruit salad.

    Larger Networks using the same systems and interrogating their phone systems in the same way should be able to create rich activity and demand data to help us argue for our share of the pie. It's a no brainer.

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  • We have nothing to lose by collecting this data but whether or not this will lead to any concrete improvements is not clear.

    The quality of the data is also important.Not vacuous bulls#it as espoused by HSL when she states "....more than 100 patient contacts when you take into account face-to-face and telephone, and helping out colleagues in training with support and second opinions". Does this mean 101 contacts or 307? Does supporting colleagues mean saying "Well done" and then adding their whole patient list to this tally of contacts?

    In some ways bad data is worse than no data, and can be spun in myriad unhelpful ways by those whose reason for existence is nothing other than producing professional obfuscation.

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