GPs cut work commitments to cope with rising workload and stress
Exclusive GPs are taking drastic action to reduce their stress levels, with many cutting the numbers of sessions they are doing, changing practices or quitting general practice altogether, say medical accountants.
Two months into the new financial year, accountants say GP partners are looking at various ways to manage their workload including reduce the number of sessions they work, changing practices or retiring. LMCs are also advising GPs to reduce their work commitments.
The comments show the beginnings of the workforce crisis predicted by the GPC and LMCs as a consequence of the hike in workload due to the contract changes that came into force from April. A debate at the recent LMCs conference last week revealed there has been a five-fold increase in the number of GPs seeking occupational health support owing to stress since 2000, many of whom go on to take retirement.
As well as the 4% pay cut predicted for GPs this year, Bob Senior, chair of the Association of Independent Specialist Medical Accountants and head of medical services at RSM Tenon, told Pulse many GPs have reacted to increased work pressures by moving from nine to eight weekly sessions, but were putting themselves under even more pressure because they are trying to fit a full time job into four days.
He said: ‘GPs are noticing the stress there’s no doubt, but whether the solution is to try to do [the job] in a shorter week and have a day off is questionable.
‘For many it is counterproductive. Those eight sessions are really long, ugly sessions. Twelve-hour days are common and, hardly surprisingly, on the fifth day they’re feeling absolutely shattered.’
He added: ‘The challenge is decreasing the workload. You might technically take some of the face to face appointments out of the equation, but that doesn’t have a direct effect on all the administration and peripheral work.’
He estimated that over half of practices now regard eight clinical sessions as the norm, although this was now becoming unsustainable due to increasing workload.
Michael Ogilvie, client service director at OBC Accountants, confirmed there was ‘definitely’ evidence of GPs working fewer sessions, with the recent changes to pensions partly to blame.
He said: ‘Especially when GPs´ profits fall into the £19,000 60% tax window above £100,000. They receive so little of the money after superannuation they would often prefer to be without it.
‘Many GPs over the age of 55 are actively considering retirement and possibly returning as partners or even locums without the superannuation cost attached.’
He advised GPs to look at sharing costs with other surgeries and even outsourcing some work to allow them to spend savings and help reduce their burden.
Ann-Marie Tulloch, partner at Dodd and Co accountants, told Pulse she had identified a big rise in GPs quitting the profession or moving practices this year.
She said: ‘Partners are either changing practices or genuinely retiring and in other cases they are leaving for workload reasons, to become locums. Others are leaving to work on clinical commissioning groups.’
Dr Michelle Drage, chief executive of Londonwide LMCs, told Pulse that they were advising GPs to review their work committments in order to reduce stress.
She said: ‘There are a limited ways of managing it but one of the key ones is to look at your workload and what you can personally remove from it – and that may involve removing you from it.’
‘We don’t have enough resourcing in practices anymore to buy in solutions. Previously we might have brought in a locum or sessional GP but those things are now unaffordable.
‘There is no money in the system or desire, which is even more worrying, to support it. So doctors are in a pressure cooker situation at the moment.’
Pulse revealed this week that six out of ten GPs would consider resigning if the Government goes ahead with its plans to force GPs to take back out-of-hours responsibility.