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Revealed: The rising tide of GP burnout as NHS cuts support

Exclusive Rising numbers of GPs are so stressed during their working day that they are at a high risk of burning out completely, reveals the largest ever survey conducted in the profession.

The Pulse survey of 2,230 UK GPs shows 50% are at high risk of burnout, up four percentage points from the same survey two years ago.

GP leaders say the health service has become an ‘industrial hazard’ and that burnout is forcing more GPs to leave the profession.

But the few occupational health schemes providing support to struggling GPs in England have had their funding cut and in Scotland NHS managers are looking at charging for their services.

The Pulse survey shows that three-quarters of GPs feel emotionally exhausted while 25% report a low sense of personal accomplishment.

Dr Daniel Mounce, a former GP in Bradford, left the profession ‘after falling apart mid-consultation’.

He said: ‘For me, leaving general practice has been like leaving an abusive relationship. The shaming and invective, the fear, the unreasonable demands were about driving down self-esteem. I can’t quite believe I ever thought I could stick it for another 30 years.’

Doncaster GP Dr Shahzad Arif, who was recently slapped with a breach notice by NHS managers after burnout forced him take sick leave, told Pulse he was ‘frustrated’ at the total absence of support.

He said: ‘I think it was perhaps something waiting to happen; there was a slight trigger that day because the practice had been unusually busy and I decided I need a break, I couldn’t go on.’

June 2015 issue cover story - GP burnout infographic 460x368

In response to the first burnout survey, Pulse launched its Battling Burnout campaign that last year won a pledge to fund occupational health support for all GPs in England.

But NHS England has yet to release the long-overdue service specifications, and in the meantime has slashed funding for previously excellent mental health support services in Devon, leaving GPs to resort to self-funding.

In Lancashire and Cumbria, LMC chief executive Peter Higgins said that NHS England scrapped the previously ‘very good’ services in 2013, and it has so far refused bids from the LMC to have mental health service put in place.

In Kent, LMC medical secretary Dr John Allingham said: ‘We are hanging on by the skin of our teeth. We have occupational health funding for next year, but nothing guaranteed going forwards.’

It is the same case in Lothian, where GPC executive member Dr Dean Marshall tells Pulse there was a counselling service and occupational health ‘but now they’re talking about charging GPs for it’.

Former RCGP chair Professor Clare Gerada, medical director of a confidential mental health service for doctors in London – said: ‘The NHS at the moment is an industrial hazard, and especially for GPs. Of course we go beyond the call of duty, but to do so every single day is causing great harm to GPs.’

Professor Gerada said her service - the Practitioner Health Programme - had been forced to shut its doors for six weeks in March after a ‘massive increase’ in demand, most of it from GPs.

It comes as the Government plans to roll out seven-day working for GP practices and NHS England’s Five Year Forward view plans for GPs to take on more care outside hospitals. The health secretary promised GPs a ‘new deal’ that will be announced this month to ‘look at why GPs have so much burnout’.

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Readers' comments (102)

  • So glad I'm out of it - nearly cost me everything health,family and my life . I feel so sorry for my colleagues still in it - you can only see it once you are outside the self perpetuating circle of abuse. My advice to other GPs is there are always choices in life .

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  • Anon@11.03 Clare referred to six clinical sessions - not just six sessions. Are you saying that hospital specialists don't get PAs for admin, paid study leave, etc? That's not the impression my sister (hospital specialist) gives. I currently work 9 clinical sessions and cope with the admin overflow in evenings and weekends.

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  • Done that "burn out" thing with "knobs on" but 2 years of therapy, change in work emphasis, avoiding uber-competetive attitude in triathlons, and regular time out with family, garden and railway restoration has restored my "calmness"

    Even considered/offered retirement on medical grounds but back "for another swing" (a good ACDC song) but wont take much to change my mind.

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  • Anon@11.32 : Intensive care consultants are not "most hospital doctors" and presumably have their own forums to discuss their pressures. Also they do get PAs for admin, study leave, etc, don't they? That doesn't imply they do not work hard and are not under pressure - just that they have more protection in that respect than GPs.

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  • Witnessed what happened the day after a GP suicide: patients banging on the desk, "Who will be my doctor now? ". My GP partner's death saved my life because I saw what it did to their family - but there were times when suicide seemed the only option and still now I feel I am a failure because general practice broke me. However, I am still here to watch my kids grow up. I was too ashamed to see my own GP as I was terrified of being referred to the GMC. There is no PHP in my area.

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  • Anon 11:52 yes, that exactly what I mean. New consutlants are now routinely appointed on a split of 8.5 DCC to 1.5 SPA, which is 8.5 face-to-face clinical sessions per week. Far too many consutlant have contracts in excess of 10 DCCs. We swap the stresses of running a small business for the pressures of having to respond to every whim of the managers, CCGs and NHS England

    I am supportive of your workload issues, but hugely disappointed at the ignorance displayed about ours, especially from your 'leaders'

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  • Doctors need to rediscover their professional status. We seem to define ourselves by our employment. We are a profession that essentially contracts to work for the NHS. If that feels like submission then we need to redefine and readjust our relationship. Alter your mindsets - Doctors are not the NHS. We are doctors.first and foremost. and increasingly doctors who understand this will avoid this unhappy unbalanced relationship by emigration.

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  • An all Salaried-Model (and definitely NOT and All-Partnership model) could also be a remedy to reduce the stress for some of our GPs - because the Salaried slaves can do all the work.

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  • At the end of the day we make choices. Theres a new contract and if you dont like the terms dont sign it and do something else. Get your professionalism back be independant and negotiate yyour own terms as private locum overseas doc or in industry etc etc. opportunities abound, 150k per year is easily achievable outside of partnership

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  • GP work has changed a lot over the last 20 years. I can no longer manage my workload and life is miserable. My friends in hospital medicine are under similar pressures and it is generally unhelpful to try and contest who has the worst of it.
    If conditions continue to deteriorate over the next 12 months then I will look to move abroad as I can not keep this going until retirement age.

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