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Patients need to be more 'accountable' for their health, suggests GP mental health lead

The lack of accountability among NHS patients is contributing to making GPs ill, the medical director of the national GP mental health service has suggested.

Professor Clare Gerada, medical director of the national GP Health Service, argued that while GPs have to give up their 'nostalgia' and adapt to the changing NHS, patients also need to take more responsibility.

Speaking at today's Westminster Health Forum on the future of general practice, Professor Gerada said nearly 1,000 GPs with issues such as anxiety, depression and addiction have now come through the service which was launched in January.

According to Professor Gerada, the GP Health Service 'is making doctors better', but she argued that to improve mental health among GPs on the whole, 'we need a new kind of practice, a new kind of doctor and a new kind of patient'.

She said practices and GPs needed to stop working 'in isolation' as this was a common driver making doctors sick. Meanwhile, GPs should be 'given time' to adapt to the changing NHS and coming up with their own solutions, making use of new technology and newly-available support staff such as practice pharmacists and physician associates.

But she added: 'If we are going to improve the health and wellbeing [of GPs] we also need a new kind of patient… I don’t think we can let patients off the hook.

'I think now, if patients want to have authority - which they are quite right to have authority over their own health – they need to also start having accountability…

'Because part of the problem at the moment is that all the accountability lies with the doctor… and the authority lies with the patient “I want this, I want that”, but if it goes wrong then if bounces back to me.'

Professor Gerada said concluded by saying that while GPs have been 'stuck on a merry-go-round of misery' she hopes the GP Health Service and other measures from NHS England's GP Forward View rescue package will instead 'instil hope' in the next generation of GPs.

Her comments come as a recent Pulse survey of over 800 GPs revealed that the stress of general practice has affected the ability of almost half of GPs to care for patients, while one in seven has turned to alcohol or drugs to cope.

The launch of the GP Health Service followed years of Pulse lobbying via the Battling Burnout campaign.

Readers' comments (16)

  • Anonymous Locum GP

    The service has been up less than a year and 1000 GPs have presented. How many are suffering but haven't presented yet? The number may be the tip of the iceberg. Think about it this way the government has promised to bring in 5000 new GPs over 4-5 years - that's the same number per year that have presented with mental health problems.

    When is our leadership going to learn - if you don't start standing up for front line GPs there will be no GPs left for you to represent.

    I have to give the Prof full credit for raising the issue - please keep high lighting it.

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  • Anonymous Locum GP

    Hand on heart - how can anyone recommend the profession when we are in this mess?

    'Because part of the problem at the moment is that all the accountability lies with the doctor… and the authority lies with the patient “I want this, I want that”, but if it goes wrong then if bounces back to me.'

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  • And still the working at scale of the Hurley group is being pushed.

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  • At at last a GP with power recognises that ultra patient centred care can be harmful and that doctors in reality have very little special powers. We just needed to be treated with the same dignity and respect that the rest of the public ask for and deserve.

    The word accountability is loaded with blame, just look at the behaviour of the GMC today if you want proof.

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  • All sounds very empathic but we need the detail. What does "patient accountability" actually mean? Accountable to whom? How would it work? Are we going to sue them for upsetting us?

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  • AlanAlmond

    Borat - I for one, would indeed like the ability to sue patients for unreasonable behaviour. I’d also like the opportunity to make some kind of formal complaint about them. Ideally something along the lines of a ‘rate my patient’ website with anonymous postings by default.
    I know this sounds ridiculous and ain’t going to happen but tell me it wouldnt be great if we could.

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  • AlanAlmond

    I’d have thought being an actual GP would be more relevant ..they do both medicine and psychiatry - bonus

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  • Alan, like you I would love it if there were some sort of recourse against unreasonable patients, but as you point out it ain't never gonna happen and I suspect that Dr Gerada knows this. Still, her comments might endear her to a few GPs.

    By the way, I think she is a qualified GP and also has psychiatric qualifications.

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  • Vinci Ho

    Asking for the 'patient accountability' seems to E logical , superficially at least . I see this sign of the times when so many of our colleagues are devastated. As I wrote else where :
    An ordinary doctor heals a disease .
    A good doctor heals a person.
    A perfect doctor heals a society.
    None of us are perfect doctors.

    But the problem is , we are required to be 'perfect' doctors so often . If William Beveridge was alive today , he would be disappointed that the Five Giant Evils had not disappeared but simply transformed themselves into a 21st century version:
    (1)Want - standard of living may be better than 50-60 years ago but this has not stopped people from wanting more. In fact , this 21st century globalisation easily has made us demand more and more.
    (2)Disease - while old known medical conditions stilll need to be managed ,we are dealing with more diseases as people live even longer but also those conditions which might not have even existed in the 'good old days'. Of course , there is also an argument of medicalising certain conditions which were not treated previously. Unfortunately, we only have a National Disease Service rather than a National (Health) Service.
    (3)Squalor- the gap between the rich and poor simply widens as the market grows bigger. Food banks in this country were rather 'uplifting' according to Mr. J. Rees-Mogg (recommend you research his whole dialogue on this matter )
    The grievance and misery are the drive behind populism towards both extremes of the political spectrum.
    (4) Ignorance- thanks to the creation of Internet, everyone has some knowledge. But what is more dangerous? No knowledge or partially knowledged?
    (5) Idleness - unemployment rate is historically low at 4.4% but many are earning low wages , the rise of which (2.2%) is not going to catch inflation (3.1%). Poverty at work is always prevalent. Social mobility is stagnant while young people would want to move up the social ladder. And as social care is diminishing, people have to give up work responsibilities to look after their older parents with illnesses . No wonder productivity is low . Inaction of our leaders on these issues is the new Idleness.

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