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Burnt out GPs denied occupational health support in NHS England U-turn over pledge to retain services

Exclusive: An NHS England local area team has pulled funding from an occupational health service for stressed and burnt out GPs despite NHS England promising to continue paying for PCT legacy services while it conducts a national review, Pulse can reveal.

GPs in Cleveland are now being refused funding for occupational health support unless their performance is under formal review, in contrast to the previous policy under the PCT. Providing support only to GPs whose performance has triggered a formal review comes ‘too late’ to help many suffering from mental exhaustion and stress, GP leaders have warned.

NHS England told Pulse in July that it had written in May to its local area teams instructing them to ‘refrain from creating interim policies and retain the historic PCT position’ pending the results of a nationwide review into occupational health funding due this month.

But Cleveland LMC has warned that its local occupational health service has been refused funding that it would have received under the former PCT and that support is now only being funded for GPs who accessed the service before April, or those with specific performance-related concerns.

Pulse revealed last week that almost 10% of GPs have had to take time off work due to stress, as the pressure on occupational health services grows. Pulse has been lobbying for better monitoring of GP workload and more nationally consistent occupational health support for GPs as part of our Battling Burnout campaign.

NHS England’s Durham, Darlington and Tees local area team told Pulse the funding of occupational health services had changed because the former PCT’s budget had been ‘redistributed’ and that it was waiting for national guidance to be developed.

A spokesperson said: ‘When area teams took over from primary care teams on 1 April 2013, funding for occupational health services changed.’

‘Before 1 April 2013 there was a mixed economy in that some PCTs paid for all occupational health support to primary care practitioners and their practices and some did not so the situation was inequitable.’

‘The former Durham, Darlington and Tees PCTs paid for occupational health services through their corporate budgets. Such budgets have been redistributed as part of a national formula-based running costs/management costs allocation process. As such there will no specific like-for-like mapping of this funding.’

‘We are still waiting for the final position from NHS England on the matter of funding occupational health services for all primary care contractors. At present, Durham, Darlington and Tees area team only pay for occupational health matters related to professional performance concerns that they commission.’

But GPC representative Dr Bill Beeby, who is a member of Cleveland LMC and a GP in Middlesbrough, warned that only offering support when a performance problem had flagged up was leaving it ‘too late’.

He said: ‘The service, as provided before, was confidential, accessed by a number of people - not huge numbers, but people who felt they were losing control - and before it all went completely off the rails they sought this help in confidence. Hopefully a large number of them would have been prevented from going over the edge.’

‘The problem is, when it becomes a performance issue […] it’s already too late, the stress has gone beyond that limit. What was simple counselling becomes something far more complicated, and something far more threatening to your livelihood. Because now, you’re out of work and no longer keeping up to date. It’s much more difficult to get back in than it ever was to stay in.’

GPC negotiator Dr Dean Marshall said the GPC was ‘extremely unhappy’ that occupational health services in a number of areas were coming under pressure.

‘Occupational health is an important service for GPs, and it’s another example of where people are looking at the cost of things, rather than the value of things. It’s extremely valuable to provide that kind of service to GPs and we’re aware that there is a move in quite a few areas of the country to remove it.’

A spokesperson for NHS England nationally said: ‘The priority for NHS England is to commission an effective, accessible occupational health assessment when necessary for any GP, dentist or optometrist on the performer list where a potential need arises.

‘This would include for those doctors whose health may become a factor in how effectively they can deliver services.’

Readers' comments (23)

  • How is this anything other than another stealthy pay cut on the profession who will have to end up footing the bill via one route or another?

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  • NEVER knew such service existed so i will not miss it. what can occupational health do to exhausted and burn out gp. they need to fend for themselves as they are self employed.

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  • disgusting

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  • I am appalled that a CCG has stopped providing this service. I had a prolonged period of depression, and the support from the London-based Practitioner Health programme was vital in supporting a return to work. Their staff understood the strains of current practice, how conflicting strains could lead to a breakdown, and how to support an eventual return to work.

    It costs £500k to train a GP (BMA figures) so the costs of these services in supporting the UK’s most expensive professionals is marginal.

    I am afraid that NHS England’s current review will merely outsource these services to the cheapest generic provider.

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  • Some self-employment has advantages. There is a certain amount of independence, rates of pay can be higher and tax treatment can be more sympathetic. But there are disadvantages too. Work can be intermittent and unpredictable; pensions must be bought from earnings; if ill-health strikes earnings cease immediately. I can’t help wondering, however, if somewhere in the big wide world there is a profession that gets the bun and keeps the penny. Now, lets think about it shall we?

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  • Just about sums up our worth. Am I really self employed? Doesnt feel like it most of the time.

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  • David, you can keep the bun and shove it where the sun don't shine.

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  • Vinci Ho

    Typical riffraff from NHSE-
    ......commission an occupational health WHEN NECESSARY. What is 'necessary' ? Oh! Just before somebody is about to hang oneself.
    NHSE does not serve for people, it only serve for politicians ........
    For the money 'saved' by cutting down access , where has the money gone to ??????

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  • Is this likely to be a recurrent problem in a lot of different service & financial areas?

    *Because* some PCTs *didn't* fund counselling and other Occupational Health services for primary care (GPs, practices & sessional HCPs on performers lists) - unlike other Trusts - the NHS England/LAT have decided that in the "interests of equity" *no-one* should get such services?

    Or has previously existing and identified funding just gone walkabout - in the same way the funding for GP IT support (added to the PCT baseline in 2004 *as recurrent income* ) appears to have done?

    "Sorting something out" next year - possibly - will be too late for many...

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  • Little support from GPs for patients with burn out - so maybe now some of you are starting top learn how that feels.

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