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'GPs who considered leaving are now working in a different way'

Dr Ilona Bendefy explains the service they run for burnt out GPs

GP-S is a project that was originally funded by Health Education England working across the East Midlands and NHS England locally to provide GPs, practice managers and practice nurses with free, confidential mentoring and signposting.

The service has been running since July 2015 in Derbyshire and Nottinghamshire, Lincolnshire joined GP-S in the last year. We are exploring extending the service to other areas in our region now that our model is fit to scale-up. Over 100 GPs have used the scheme so far and their feedback has been highly positive, with many who had considered leaving the profession remaining as GPs often working in a different way.

All our mentors were originally GPs – many are appraisers and/or involved in training and education. We started with ten mentors, we now have 30 because of demand.

In the last four months we have undertaken two pilot schemes with practice managers and nurses being trained as peer mentors.

In an ideal world we would offer mentoring to everyone working in primary care, however funding is limited. We have been working with doctors making career decisions at any stage of their careers. We are also there for doctors in difficulty or who are no longer enjoying work, may be feeling overwhelmed or simply that ‘something is not right’. The mentors are trained in the Egan ‘Skilled Helper Model’ which allows facilitated reflective change. We do not tell GPs what to do, they decide for themselves. We are not aimed at people who have mental health problems (the NHS GP Health programme is there to help them or we can signpost them to counselling).

We always tell appraisers about us as this is a key way GPs are signposted to our service, especially new GPs moving into the area. We’ve also been working to make appraisal itself a more supportive process rather than just box ticking.

Mentees receive up to four free two hour sessions during a six to twelve month period. It’s rare they need more than four sessions. Mentors are paid, have indemnity and receive ongoing support from GP-S through group training and supervision sessions.

As mentor lead for Derbyshire I handle all mentoring requests from potential mentees across the county who have contacted the service on-line or by phone, occasionally in person. I talk to them for about half an hour explaining more about the service and complete a pro-forma with details of what they are looking for. If we agree mentoring would be useful I match them with a mentor nearby checking there are no conflicts of interest such as knowing them socially or close working.

Since some referrals will be coping with performance issues, we ask our local team to signpost all such doctors to us for support. We also check they are registered with a GP, their level of home support and signpost to additional services such as counselling and/ or GP health.

GPs outside our area could set up similar schemes and we are happy to share our experiences with them and offer advice and resources. We feel that we have a model that allows for a ‘hub and spoke approach’.

Dr Ilona Bendefy, GP-S mentor lead for Derbyshire

A typical case 

We are approached by a newly qualified GP who has taken up a salaried role in her training practice. She is willing and able but feels she is working constantly and can never get on top of her work load.

She also feels she is still treated like a trainee and does not have a voice in the practice. The partners are always too busy to talk and do a lot of work outside the practice leaving her to cope on her own much of the time. She wants to look at her work options and how to be more assertive.

The first mentoring session is talking about what’s going on and looking at her situation from lots of perspectives. She leaves to reflect on her thoughts and to decide what area she most wishes to change.

In the second session she has realised she wants to focus on how to enjoy working again and feel more confident. In the third session we look at how she is going to achieve this. She realises she needs to try working in a different environment as she feels she will always be viewed as the ex-trainee.

She decides to leave the practice and try locum work to experience different ways of working. We signpost her to the local sessional GP group for additional resources and locum support. In the fourth session several months later, later she has been working as a locum and been offered a salaried post in a regular practice where she feels more confident, is enjoying work again, has a work life balance and feels more equal to her new colleagues. She is grateful to all the help and has recommended the service to other GPs.

 Details have been changed to protect confidentiality

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Readers' comments (18)

  • SUMMARY

    "GPs who considered leaving"=EVERYONE

    "now working in a different way"=RECOMMEND LOCUMING.

    SO THE SERVICE BASICALLY RECOMMENDS LOCUMING.....THERE IS "NO OTHER WAY"

    IF I PHONE UP AND SAY I WORK 12 HOURS PER DAY, NEVER SEE MY FAMILY, HAVE LOTS OF STRESS AND EARN ALOT LESS THAN A LOCUM, WHAT CAN THEY DO FOR ME....NOTHING OTHER THAN SUGGEST I CHANGE MY WORK-LIFE BALANCE WHICH IS CODE FOR LOCUMING.

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  • When do they find time to go and be " mentored"?

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  • re: Last Man Standing | GP Partner/Principal 27 Jul 2017 10:07am

    Please don't insult fellow GPs and the great work GP-S is doing.
    Sadly, most GPs don't have a clue about what mentoring/ coaching is about.
    It is better to have some constructive comments. If you are still doubtful, have a session and you will find out.

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  • While I applaud the sentiment and undoubtedly it is important for us all to have support we can turn to.I think it's partnerships that need mentoring as a whole . To get any result the whole team needs to be helped - we don't work as individuals.
    In the example the initial practice will now suffer as they lost their salaried doctor - instead of looking at a team based approach to resolve the issues.
    Moving the individual doctors around isn't going to support the system it's not really resolving things to just leave surely an intervention would be the first step.

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  • Cobblers

    Not having a pop at mentoring here but most of these poor unfortunate GPs are being overworked in whatever capacity.It is no longer fun.

    The mentor uses their own skill set to suggest change which almost invariably means less work or work in a capacity where you have more control i.e. as a locum.

    As a great GP once said 'R L E'.

    Retire, Emigrate or LOCUM.

    COI - A Locum. Fun it is too.

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  • Council of Despair

    Last Man Standing | GP Partner/Principal27 Jul 2017 10:07am

    I agree with you.

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  • I also agree with Last Man Standing.

    I gave up being a partner, to be salaried. It is still too much of a daily grind. Next step is retirement. Life is too short to be unhappy.

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  • David Banner

    So burnt out ex partners are repatriated as locum/salaried doctors. Good for them. But as all remaining partners either desert or go down with the sinking ship, it's a squalid and pathetic end to a system that made UK Primary Care great for 70 years, choked to death by politicians intent on grabbing control from partnerships, whatever the cost. They'll miss us when we're gone.

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  • @ 2.41

    But they'll have moved on and escape accountability like they always do. In any case most of the politicians will be able to afford to go private (initially) rather than wait for a noctor, proctor or one of the GP's that's left.

    The NHS will remain a good service for the very poor but as is increasingly the case, not good for working people by international comparisons.

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  • doctordog.

    Working in a different way=working less.

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  • Yes workin less is the new way LOL Im amazed that so many people can continue to work in these high intensity jobs for years seeing 40 + patients with all the admin and running a practice on top. uuurgh!

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  • Great idea, not coping with stress of partnership, huge patient demand, amin etc? Become a mentor!!

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  • So one Salaried is mentored and leaves to be a Locum - presumably leaving the other GPs at the
    working harder/drifting towards burnout .
    That is not working different - it's working less which as a GP Partner rarely is a viable option . Who finds and funds these mentors ?

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  • Being mentored was the best thing ever to happen to me in my medical career. Sadly, I was not aware of it until after I had imploded through over-work.
    I think mentoring should be compulsory from day 1 of our careers and not something that is found when a doctor has "failed" in some way.

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  • It has been really interesting to read all your comments. All I can say is that we are trying to help our colleagues in primary care as best we can through what are undoubtedly stormy times in the NHS. GP-S was set up after we saw that many of our peers were facing huge challenges with little support. We wanted to change this and hope we can make a difference to those individuals we work with. Yes we may help them explore their work/ life balances but we can also look at their personal lives, career development, finance and additional support.

    We would love to help practices as a whole and colleagues from a wider geographical area, but have limited funds so we do what we can at an individual level in local counties through GP-S (Derbyshire, Nottinghamshire and Lincolnshire). We are running pilots working with practice nurses (in Notts City) and practice managers (in Derbyshire). We also offer the service to GP ST3s (who have applied for their CCT) as many want to consider their future career aims. We are supportive of other areas working with us subject to them finding the funding.

    We continue to talk with colleagues with the LMCs, BMA, NHSE, RCGP and new GP Health service in the hope they will be able to influence the bigger picture for the NHS.

    If you’d like to know more about GP-S you can visit www.GP-S.org or follow us on @GPS mentoring.



    Dr Ilona Bendefy GP-S mentor lead for Derbyshire

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  • I am one of the GP's involved in this. I knew nothing about mentoring until I was trained in this for one of my roles. As part of the training, I had mentoring. Basically, mentoring should never tell you what to do, but it certainly facilitates focusing down on what the issue is and is a practical way of developing a strategy to cope with it. It helps the individual to identify potential solutions. Quite often the issue initially brought is not the one we end up focusing on at all!
    I can't tell you the sort of things brought to mentoring (confidentiality is massively important), but can tell you it is far more diverse than career. It is one of the most satisfying roles I have ever done, as it is totally focused on supporting a colleague. (No reports, no tick boxes!). I know it has made a difference, and certainly not just with respect to work issues.
    I agree with one of the comments above that a whole Practice approach is sometimes what is needed. I know of Practices that have done just this, though not through GP-S.
    It cannot fix underfunding, it cannot fix Patients unrealistic expectations, but it can, and does help individuals.
    I am biased and I guess I have a potential conflict of interest. I work with GP-S and I have had mentoring myself. They did not ask me to write this though, I just feel strongly that this is a service that is good for GP's and that it can help. Helen.

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  • I think I might be in the minority and might get shot down but here goes:

    - Being a partner is not always as bad as people make out.
    - Working 5 sessions as a partner certainly means working harder than 5 sessions as a locum, but you need to make a more reasonable comparison.
    - Working 5 sessions as a partner might mean less hours, more money and more variety than 7 sessions as a locum or 9 sessions as a salaried doctor.

    Those types of partnerships do exist. It just takes an open mind to seek them out.

    With that in mind the mentoring might just give someone the confidence to leave a job they are in to take up a role elsewhere... as a partner.

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  • But who mentors the mentors?

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