Around one in 20 GPs in England are currently accessing mental health services via NHS Practitioner Health, according to shocking new data.
CEO Lucy Warner said roughly 2,400 GPs are on their caseload, which is 5.3% of the total 45,637 GPs across the country, with older GPs and partners now more heavily represented than previously.
The service, which provides treatment to healthcare professionals who are mentally unwell, was intended to serve between 0.5% and 1% of GPs when it began nationwide in 2016.
Just before the pandemic, the percentage rose to one in 50 GPs (2%), which Ms Warner said was on par with other similar services globally.
However, from 2020 there has been a ‘significant growth’ up to around 5% for GPs, which compares with a 4.5% average across all doctor specialties.
Ms Warner told Pulse that where other specialties had ‘really significant sprint stages’ during the pandemic, GPs have been ‘running marathon after marathon after marathon’.
While the increase between 2016 and the pandemic could be put down to ‘growing confidence’ in talking about mental illness among health professionals, the increase to the current caseload is likely due to mounting workload pressures, according to Ms Warner.
She said: ‘I feel that this significant growth up to 5% is linked to the level of burnout because when people fill in their forms, so much of what they talk about is workload – how much they’re struggling, how anxious they feel about their workload.’
NHS Practitioner Health has also noticed a trend towards older GPs and partners taking up the service rather than younger GPs.
Ms Warner said what makes the GP caseload distinctive from other medical colleagues is that in their self-referrals they tend to describe themselves as ‘the last man standing’.
She said: ‘What we’re seeing in the service now is not so much of the younger GPs coming through. We’re seeing the people who you might have perceived to be the most resilient – the partners, the older doctors, who’ve just carried on.
‘Other people have needed to take time out to deal with things like taking care of children who needed home-schooling during the pandemic or elderly parents – those people who have had to take a break because their support structures have fallen by the wayside.
‘What we’re seeing now is that the ones who kind of bore the burden for everybody else over the last few years, they’re the ones that are now seeking help for themselves.’
Professor Dame Clare Gerada, an ambassador for NHS Practitioner Health who is also a GP and president of the RCGP, told Pulse there is an ongoing issue with ‘GPs being seen as both the scapegoat and the saviour of the NHS’.
She said the rise in service users is due to GPs in particular ‘suffering with something called moral injury, which is feelings of guilt, shame and anger, and not being able to deliver the care they want to deliver for their patients through years – decades – of underfunding.’
Professor Gerada, who is also chair of the charity Doctors in Distress which is dedicated to stopping suicide among healthcare workers, blamed the media coverage of GPs too.
She said: ‘I think, whatever anybody says, we are taking the full brunt. So when the papers say there’s a queue for surgery, they don’t say “surgeons aren’t working, surgeons are part-time”. But whenever you hear about general practitioners, it’s always personalised.’
Chair of the RCGP Professor Kamila Hawthorne said the new data on GP uptake is ‘deeply concerning’ but is ‘no surprise’ given increasing workload and pressures.
She added: ‘We feel deep moral distress when we cannot deliver the timely care that patients rightly expect – unfortunately, 68% of us now think workload is so severe that patient safety is at risk.
‘Practitioner Health delivers an essential service to professionals struggling with the immense pressures in primary care, by providing high quality support that helps them restore their own wellbeing.’
NHS Practitioner Health, which was set up to provide mental health treatment to those who cannot access care confidentially, offers assessment, prescription of medication, therapies and further case management to GPs and other health professionals in England and Scotland.
There were 184 new registrations in the last week of 2022, which was the same number of total registrations in the whole of their first year as a service in 2008.
A recent survey by the Medical Protection Society found that almost half of GPs said the fear of being sued or investigated due to incidents arising from staff shortages is affecting their mental health.
From April, a new QOF indicator was introduced which focused on reducing the risk of GP and practice staff burnout as well as shoring up resilience and wellbeing.