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New wellbeing QOF indicator to reduce GP burnout risk

New wellbeing QOF indicator to reduce GP burnout risk

Reducing the risk of GP and practice staff burnout, as well as shoring up resilience and wellbeing, will form part of QOF activity for practices from April.

Practices will also have to take steps to create a compassionate and inclusive culture within general practice, under the Quality Improvement workforce and wellbeing indicators, which are a new addition this year.

Latest QOF guidance, published yesterday, says practices should first conduct a review of all work-related factors that affect wellbeing focusing, in particular, on workforce planning, including access to flexible working, reasons for absence, and the support provided to different staff and new starters.

Surgeries will then have to draw up and put in place a plan to improve outcomes. What HR measures that includes will be up to individual practices to decide though the guidance does include suggestions.

To address wellbeing, resilience and burnout, the guidance says, practices should ensure stress risk assessments are carried out for each role (as required by the Health and Safety at Work Act 1974). But they could also offer support on mental wellbeing by, for example, introducing a mental health champion and encourage staff to engage with support programmes such as the free, confidential Looking After You too scheme or Practitioner Health, it is suggested.

To create a compassionate and inclusive culture, practices are advised to consider all flexible working requests; ensure staff in a leadership role have access to training on compassionate leadership and how to lead a team; create a ‘buddy’ system for new starters; make sure all general practice staff have an annual appraisal that looks at training and development needs; take action to prevent discrimination, and more.

To gain another 10 QOF points, practices will also have to participate in at least two PCN peer review meetings to ‘regularly share and discuss learning from quality improvement activity focused on workforce and wellbeing’.

The guidance says: ‘There is a clear need to focus on supporting and improving the wellbeing of the general practice workforce. The pandemic put a significant additional strain on the workforce and the demands on general practice remain high. This module aims to provide practices with the means and resources to evaluate how they currently support their staff and aims to enable the introduction of processes and initiatives that will provide structure and support to staff on a long-term basis.’

It adds that: ‘We know that practices will be at different points in relation to supporting the wellbeing of their workforce therefore these resources are designed to be used in a flexible way to meet individual organisational needs.’

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RCGP President Professor Dame Clare Gerada said while it is good that at last someone is focusing on GP wellbeing, forcing practices to implement audits like this is not going to sort out the real issues, which is workload – especially the workload of GP partners – and a lack of workforce.

‘It is akin to resilience training for hospital doctors. In other words, the response to intolerable workload pressures and lack of compassion in the workplace is to put the locus of disturbance into the individual, who is then made to do resilience training. I am also not sure how we are going to translate this work into something that actually increases wellbeing, when we have so desperately to fill workforce gaps,’ she added.

Professor Gerada, who is also chair of Doctors in Distress, said a better option for GPs would be to ensure they have access at practice level to ‘space for reflection’.

‘This should be protected time and fully remunerated and would ensure doctors can work together to explore the emotional impact of particular cases and general workload. This should be in place of all the mandatory and statutory training NHS England requires us to do.’

Tony Brown, managing partner at Alnwick Medical Group in Northumberland, said he agreed that a positive culture and team ethos not only helps with general wellbeing among the team, but helps to provide better patient care and further enable local recruitment.

However, he added: ‘The best welfare we can give to the team is to pay them properly, but practices can’t afford to do that.

‘I don’t see how government can say all of this about staff welfare when they have only given an uplift to the GP contract of 2.1%.

‘It’s another example of NHS leaders being so far removed from general practice that they don’t understand the real issues.’

Earlier this week BMA GP Committee England (GPCE) negotiators advised GPs that, to avoid the risk of burnout, they could ignore the new two-week appointment requirement in the IIF due to the relative low level of funding attached to it.

A version of this article was first published by Pulse’s sister title Management in Practice


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Please note, only GPs are permitted to add comments to articles

Russell Eldridge 31 March, 2023 12:42 pm

They are a day early in announcing this, the 1st of April is tomorrow.

Iain Chalmers 31 March, 2023 12:46 pm


Glad I’m done with this sort of steamy brown pile

David Mummery 31 March, 2023 12:47 pm

April fools day is tomorrow !

Lise Hertel 31 March, 2023 12:47 pm

Sick joke.
They are not out of touch, this is completely intentional’
You must be made to be happy, if you say you are happy we will pay you, but if not, we won’t pay you!
Anyway its all your fault because you aren’t resilient enough!
very 1984.

fareed bhatti 31 March, 2023 1:03 pm

‘To address wellbeing, resilience and burnout, the guidance says, practices should ensure stress risk assessments are carried out for each role..’
Just reduce our work load and stop slating us – that’ll be enough thank you.
Positivity, compassion and inclusivity dont do the work for you.

Wolfgang Wallat 31 March, 2023 1:08 pm

The amount of work doing all those assessments is insane, and we’re going to be blamed for staff going down with stress! Would be meaningful if NHS England and the CQC were doing those!

Not on your nelly 31 March, 2023 1:09 pm

hahahahahahahahahahahahaha! I thought the 1st of April was tomorrow?!

Turn out The Lights 31 March, 2023 1:12 pm

What are NHSE+ the government on.I have some of that.Too much nitrous and charlie I bet.

Daryl Mullen 31 March, 2023 1:12 pm

So crass. So NHS England

Andrew Jackson 31 March, 2023 1:16 pm

This is appalling. If you don’t do it does this make you more liable for work related stress as an employer?

Nathaniel Dixon 31 March, 2023 1:21 pm

Completely beyond satire, do all you can to make a profession utterly toxic and then create a QOF wellbeing indicator.

Simon Gilbert 31 March, 2023 1:43 pm

Is the Gp contract now micromanaged so hard it counts as disguised employment (apart from the unlimited liability)?

David Church 31 March, 2023 1:44 pm

So practices will have the power to increase staff pay as much as they like, whilst allowing flexible working and reduced hours, only seeing the nice, clean, polite and grateful patients, and able to censure the national newspapers and other media?

Turn out The Lights 31 March, 2023 1:48 pm

Abusive.The kind of sentiment a abuser says to the abused.They blame the victim.Victim blaming it is then.

Some" Bloke 31 March, 2023 1:59 pm

I’ve just done the stress risk management review and identified NHSE and Dept of Health to be the main causes of stress for GP Parteners and other clinical staff. Now, what measures can I put in place to protect our staff from burnout caused by these idiots?

john mccormack 31 March, 2023 2:56 pm

utter codswallop

Mike Pearce 31 March, 2023 3:37 pm

Simon Gilbert comment…absolutely spot on

Christopher Ives 31 March, 2023 3:50 pm

Is this an April fools? I ask this seriously as I am already worried about how we are going to implement this if its true. I would have significant concerns regards staffing if we allowed totally flexible working. This is going to create increased stress on management and partners.

julian Wadsworth 31 March, 2023 3:50 pm

This isn’t about gp partners being happy, it’s for the team to be in a nice cosy warm nirvana.
They can go to a safe space, down tools early work in their patient facing roles at flexible hrs ie when we are shut. I don’t see anything other than more staff headaches and more s**t landing on us as we have to backfill for our absent stressed receptionists, assistants and nurses so as meet our contracted hrs.
I am not sure how much more I can take.

2.1 % doest allow me to increase or fairly pay my staff

Not on your nelly 31 March, 2023 4:17 pm

NHSE in full gas lighting mode.

Not on your Nelly 31 March, 2023 5:04 pm


Andrew Hill 31 March, 2023 5:23 pm

So additional work to do…to make sure we don’t burn out from additional work

Sam Tapsell 31 March, 2023 7:05 pm

BS001 – Identify and maintain a list of useless lists, termed BS
BS002 – Create a 10 point action plan to reduce the BS lists, which should include the words “cloud, technology, innovation, AI, mobile, training, hybrid”. Please make sure list does not include the words “funding, workforce, retirement, new goverment, gary lineker”
BS003 – Share your BS001 / BS002 lists at a network meeting, highlighting shared learning. The meeting should not affect any day to day work at involved practices, so preferably nobody should attend.

Jonathan Mounty 1 April, 2023 12:25 am

Please continue rearranging the deckchairs on the Titanic whilst even more ludicrous ideas are dreamt up snd imposed.

Faen Faen 1 April, 2023 7:16 am

The answer it seems is to quit en masse. It’s the only way things will change, if doctors vote with their feet.

Alice Hodkinson 2 April, 2023 9:35 am

GPs told to make themselves more resilient by filling in more forms.

We all know that “resilience” is a swear word in GP. As is QOF. Removing one would improve the other. Guess which.

April Fools

Dave Haddock 2 April, 2023 3:10 pm

Please name and shame the people responsible.

Dr No 2 April, 2023 8:20 pm

I got quite pissed off about this one till I realised it was an elaborate April Fool’s Day spoof article. It’s very funny on re-reading. Well done whoever wrote it. It is a joke isn’t it?

John Graham Munro 2 April, 2023 11:20 pm

Overheard at the Port of Dover——–”I’m having to pay for a locum to allow me to sit in this traffic jam”

Michael Green 3 April, 2023 7:08 am

Does this one come with a set of crayons?

Carpe Vinum 3 April, 2023 1:40 pm

Dear doctors, here at NHSE we appreciate you are exhausted, burnt out, disenfranchised and overwhelmed. To counter this, we will ask you to spend an inordinate amount of time (which you don’t have) and energy (which has by now wholly evaporated) in doing an exercise which will increase your burnout rate, increase dental practitioner visits through teeth grinding (even though there are no longer any dentists) and ultimately have zero net benefit on the wellbeing of your employees, However, this should hasten the demise of the partnership model opening the door to the glory days of Franchised Health care PLC.
Kind regards

Daryl Mullen 5 April, 2023 10:21 pm

If the BMA actually had any guts it would refuse to be involved in this gaslighting nonsense.
Or we can all just use GPT3 to write our “wellbeing programs”

Dr No 6 April, 2023 11:47 pm

Oh just lie! Pretend you’ve done it in the Grand tradition of appraisal. It’s the only professional course of action. Presented with bullshit which takes you away from seeing patients, spray some fabricated bullshit back! NHSE are obv so bloody thick they’ll never notice.

Daryl Mullen 29 June, 2023 7:30 pm

Here’s an idea we club together and have a unified response that says we’ve increased our resilience by saying duck off to this indicator