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Gold, incentives and meh

Workload and red tape drive GP stress up to record levels

GPs' job satisfaction has sunk to its lowest recorded level, Government-funded research has concluded.

The survey of 2,000 principals, 600 salaried GPs and 400 locums in England found rising workload and inadequate pay were the greatest cause of stress. It also concluded that principals were less satisfied than salaried doctors, male GPs were less satisfied than female GPs and GPs aged 40-59 were the least satisfied group.

Overall, job satisfaction was significantly lower among principals when the survey was carried out in 2001 than in a similar study in 1998, the National Primary Care Research and Development Centre found.

Satisfaction was also lower than in 1989 and 1990.

Of the 30 potential causes of stress among GP principals, stress levels rose for 25 factors during the three-year period. Increasing workload, paperwork and insufficient time to do the job topped the list of anxieties.

The research, published last week, concluded: 'Improving the fit between GP job attributes and job expectations by moderating the pace of change, improving pay and enhancing job flexibility may help to enhance GP well-being.'

Study author Professor Bonnie Sibbald, deputy director at the centre, said the new GMS contract would help address these issues. 'The contract looks like it will give GPs greater control over the range and type of work the practice undertakes. There are opportunities for skill mix and the contract makes it easier for GPs to become salaried,' she added.

'But there is a problem with poor distribution of GPs in relation to population need. I would want the contract to carry more incentive to work in deprived areas.'

Dr Rob Dawson, whose three-partner practice in Gateshead, Tyne and Wear, was forced to shed 1,000 patients after a partner left earlier this year, said GPs were 'now running on vocation'.

He added: 'Unfortunately the Government is writing cheques we can't keep. I want them to stop raising expectations. I doubt the contract will solve my problems. I have very little faith in it.'

Factors causing rise in GP stress levels

1998 2001

 · Increasing workload 3.78 4.24

 · Paperwork 3.47 4.18

 · Insufficient time to do justice to job 3.41 4.14

 · Increased demands from patients 3.77 4.09

 · Changes imposed by HA/PCT 3.44 4.00

 · Inappropriate demands from patients 3.64 3.86

Table shows mean stress score on a five-point

scale (higher rating means greater stress)

Source: NPCRDC

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