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Older GPs’ ‘concentration goes’ after 4pm, NHS burnout guidance suggests



A local area team has issued guidance suggesting GPs should avoid burnout through flexible working patterns that allow older GPs ‘whose concentration goes’ after 4pm to work mornings.

The guidance, issued by the NHS England Bristol, North Somerset, Somerset and South Gloucestershire (BNSSSG) area team, says that flexible working arrangements can allow GPs to ‘survive and thrive’ while working harder than ever.

This advice comes as NHS England are due to issue guidance on what occupational health services GPs are entitled to. Head of primary care development at NHS England Dr David Geddes said last May that this would be ready within ‘four months or so’.

NHS England agreed to fund a national occupational health service after pressure from Pulse’s Battling Burnout campaign, which recently found four in ten GPs had taken time off because of burnout.

But Pulse has previously reported that existing gold-standard occupational health services are already being cut.

The latest advice from the BNSSG area team says practices should target working patterns to clinicians’ lifestyle or skills.

It says: ‘Doctors who work in a flexible practice where consideration is given to their individual needs appear to fare better than those that have a rigid attitude to patient lists and equitable workload. An example of this is the older partner with adult children who is happy to work early extended hours in the practice but finds that after 4pm his concentration goes, complements the younger doctor with primary school aged children who needs to do the morning school run, but is happy to work later.’

The advice also suggests allowing slower partners to take on ‘heart sink patients’  who need longer appointment slots, and warns against ‘shoe horning’ salaried GPs into another doctor’s agenda.

It ends by flagging up local pastoral support schemes provided by LMCs in Devon, Cornwall, Avon and Somerset and says: ‘We are all working harder than we ever have before and if we want to thrive and survive it is essential that we look after ourselves and each other.’

But Dr Peter Swinyard, chair of the Family Doctor Association and a GP in Swindon, said: ‘I regret that under the pressure we suffer, the chance of this comradely flexibility is as likely as a substantial GP pay rise.’

He added: ‘Sadly many partnerships work in very rigid ways and always have done. Even when there is the goodwill to allow a gradual return to work there are confounding factors – after four months off last year, I was meant to ease myself in during August. Unfortunately, by week three there was GP holiday and lack of locums and I ended up full time after two weeks not four.’