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‘Shocking’ numbers of GPs seeking pastoral support, say LMCs



Exclusive Spiralling practice workload has led to ‘shocking’ numbers of GPs who require pastoral help as many struggle to cope with stress and mental health issues, LMC leaders have claimed.

Figures from one LMC show a four-fold increase in the numbers of GPs presenting to pastoral care services in the first half of 2012 compared to the same period in 2011, and a doubling of the numbers overall.

The Cameron Fund, a charity that provides financial support to GPs suffering ill health, disability, death or loss of employment, has also witnessed a rise in applications. The charity received 265 requests from GPs or their dependents in 2011 and 2012, compared with 121 requests in 2010 and 2009.

The concerns come after an LMC-run survey of some 2,700 GPs across the South West found half were considering quitting general practice and two-thirds believed their practice would struggle to remain viable due to the Government’s planned contract changes. Last year a major study published in BMJ Open suggested almost half of GPs assessed using the validated Maslach Burnout Inventory tool fitted the criteria for ‘emotional exhaustion’.

LMC leaders said they feared the additional work set to be included in the new GP contract from April would make the problems worse.

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In Devon, 33 GPs presented to the LMC’s pastoral care services in 2012, compared with 17 in 2011. Dr Mark Sanford-Wood, executive chair of Devon LMC, said he had witnessed an ‘enormous rise’ in requests for help, advice and support from GPs, in particular from partners suffering with stress and burnout, and alcohol and drug abuse.

He said: ‘This is quite shocking. The Government have to realise their changes have very real effects on GPs.’

Dr Robert Morley, executive secretary of Birmingham LMC said: ‘Pressure from CQC [registration], revalidation, sweeping contract changes, years of a pay freeze, rising expenses and spiralling workload are the reasons for this.’

‘It will only get worse as patients’ demands and expectations are fuelled by cynical and self-serving politicians at the same time as the contract imposition slashes practice resources and the CCG agenda gives GPs statutory responsibility for rationing,’ he added.

Dr Nigel Watson, chief executive of Wessex LMCs, said that there had been a 100% increase in GPs presenting at the LMC’s pastoral care services this year compared to last.

He said: ‘There’s workload saturation already. GPs are thinking about retiring, going abroad and then there’s increased pressure on the remaining workforce. Some practices are just not getting suitable applicants for jobs.’

‘It’s definitely going to get worse. All the factors contributing – ageing population, chronic and long term disease management, increased workload and lack of investment – will mean GPs will just work harder to do what they have to do. It’ll put them under a lot of pressure which will affect their health.’

Dr Peter Graves, chief executive of Bedfordshire and Hertfordshire LMC, said he was so shocked by the increasing need for pastoral care that he was petitioning NHS managers locally to set up a specific support service for GPs.

He said: ‘For about 15 months now I have seen an unprecedented number of GPs presenting for pastoral care for unacceptable levels of stress, right up to full-blown serious mental illness. I have been struck with not only the numbers but also the severity.’

‘It has resulted in me putting papers to the PCTs and CCGs to propose that we set up a Practitioner Health Programme similar to that in London. I will be pursuing this relentlessly.’

Dr Beth McCarron-Nash, a GPC member, former GPC negotiator and GP in St Columb Major in Cornwall, said: ‘The perfect storm we’re entering means GPs want to retire, and vacancy rates are rocketing. A GP being stressed will obviously have an effect on patients.’

‘On top of this a lack of investment has meant many GPs cannot take on more partners to share the burden.’