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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’.

Related images

  • Battling Burnout Logo
pulse gp survey nov2018 180x250px v1

Readers' comments (102)

  • Listen folks forget about the work any organisation or leader is doing to help with this rot.

    Take your health, sanity, career and future back.

    Quit this god forsaken rat race. Doctors are dropping dead and suiciding now. It's beyond debate. Those who burnout are the lucky ones..........

    Whichever way you can get out just do it. Why care for a system that drives you into an early grave. Get out get out get out...! Whatever you can do get off the front line. Teaching, locuming, politicking, retiring, emigrating, all of these options are better than what you'll see carrying on. Nothing is about to change anytime soon. Don't trust the politicians and "leaders of the profession"- they're all in cahoots afraid. They sit around the same tables and agree to the policies that persecute you, then publicly disagree....your playing against an opponent with loaded dice, with all the cards on their favour. Your being played and your future stolen.......

    Don't let them take from you what's most precious..... Don't give them the satisfaction. Walk away, run away fly away. Whatever it takes, and don't come back........

    I learned this lesson as a a newbie partner. Realising that the representatives didn't represent me and the older generation having a different agenda to myself I resigned and moved abroad.... Life had never been better. If there is a heaven after this life it could not be sweeter. I'm a doctor again. A professional. A somebody...... I would rather stack shelves in tesco (if I ever came back) than work in the NHS.

    Your all autonomous and valuable..... You've just forgotten

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  • 3.59
    Very well said. It is not worth continuing doing this nonsense.

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  • totally agree with Clare.We must not be divided as a profession hospital/GP/partner/salaried.Work in Devon and just today signed cheque to pay for Occ health and separate for mental health support. the powers that be know a core group of us are tied in financially, if you can retire now and this should rack up the pressure when patients find themselves without a GP then the tide should turn.until then do not volunteer for anything, goodwill has gone.

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  • Clare G - we need facts and statistics or they just don't believe us. We know litigation rates are rising. We know colleagues struggling with workloads.

    Dear Editor

    Can you seek FOI Act statistics from:

    1. Area Teams about numbers of GPs going through remedial measures / performance assessments. Change in rates compared to previous years. Health concerns.
    2. Trend in the number of GPs formally referred to NCAS or advice sought.
    3. GMC referral rate for GPs, stages closed at or outcomes. Health concerns or otherwise.
    4. Numbers of GPs formally referred to Occup Health services by employers, Area teams.
    5. NHS England or Area Team complaint rate statistics and on what sort of areas that might be linked to burnout and unreasonable demands. We all know patients who formally complain when we run 45 mins late, want us to deal with 4 problems then complain when we don't etc

    Can we quantify some of the unreasonable demand somehow?

    Could we find a solid association between under-doctored areas and "burnout" problems and "possible" consequences for doctors and patients?

    I agree with Clare Gerada ‘The NHS at the moment is an industrial hazard, and especially for GPs." clearly there is a knock on effect to patient care in some areas so the burden of this responsibility needs some shifting away from individual doctors trying their best at the "coal-face" under extreme pressures.

    I am not sure we are exaggerating this crisis or ever have been to those detractors. We must surely need a revolution...
    DB

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  • 4:19pm

    And also average number of Clinical Sessions that doctors in different areas of UK are working.

    Also the average number of Clinical Sessions that Partners and Salaried GPs are doing.

    After how many Clinical Sessions there is significant burnout.

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  • Don't forget about all the nurse practitioners and staff nurses working in urgent care settings that although should be on 12 hour shifts are very often not getting home before 13.5 hours have gone by,
    Break is only 30 minutes in the middle of the day, morning and afternoon breaks stopped as we are allowed drinks throughout the day. If we can slip out of the room to make a drink rarely get to drink it as expected to carry on working, Tea not quite the same when cold. Only paid a fraction of what the doctors are too!

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  • We hold so much potential power. Literally millions of people want to see us every day.
    Time to leave the NHS?

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  • im sure the law states a 15 min break every 4 hours?

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  • When youve been drinking cold tea for 20 years you get used to it.any fluid is better than no fluid.Also my dinner time consist of a sandwich/crisp and pop deal while doing visits or at my desk while working(very healthy).GP land is far for healthy at the moment.

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  • Clare - don't take the critics to heart - you were and still are very popular, the problem was a lot of people expected a lot more from you than you could have ever reasonably delivered. It was unfair of them to expect you to singlehandedly solve the problems in general practice. Because you couldn't 'magically' solve the issues you took the blame.

    I don't think any single leader can possibly deliver the type of change needed to help the profession hence we get a lot of excellent speeches but no action. We have to find a way to work together and deliver effective action. That's the challenge.

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