Working in general practice is often ‘lonely’ and the unsustainable workload pressures facing GPs is harming relationships with patients, according to a major independent review commissioned by the GMC.
The report, which looked at the wellbeing of doctors and medical students across the UK, also found GPs are burdened by the ‘requirements of multiple regulators’ which leads to feelings of helplessness and alienation.
GPs also experience ‘denigration’ from other specialties, which causes resistance when they refer patients to secondary care, said the review, called Caring for doctors, Caring for patients.
Those behind the review called for more effective teamwork, minimum standards for basic workplace facilities and a review into workload to improve the wellbeing of all doctors.
In response to the findings, the GMC said it was clear the demands placed on doctors ‘are now so great they risk becoming unmanageable’ and that it would use ‘all our…powers to support doctors and medical students’.
The GMC commissioned the wide-ranging review of doctors’ wellbeing – led by psychologist Professor Michael West and clinical psychiatrist Dame Denise Coia – following work it had carried out looking at the impact of investigations on doctors.
Today’s report cited existing research that found: ‘Poor working conditions (high workload, low job autonomy, long hours, low social support, work-life conflict) and poor mental health (high burnout, symptoms of depression and anxiety) are associated with an increased intention to leave medicine.’
It recommended GPs have more say over their workplace culture through leaders obtaining feedback from staff, which is said to generate a more ‘compassionate’ leadership model.
The review concluded that doctors must have an ‘ABC of core needs’ – consisting of autonomy/control, belonging and competence.
The report also warned newly-qualified GPs are struggling with the demands of general practice. It called for the GMC to work with the UK Government to develop strategies to ‘better support the ongoing development of all doctors outside or after formal postgraduate training’.
It added: ‘This should establish new ways of working to improve the capacity and confidence of newly-qualified GPs and specialists and the retention of experienced doctors in the NHS.’
Professor West said GPs are exposed to different pressures than secondary care clinicians but are ‘no less important’ and are still ‘potentially’ harmful.
He added: ‘GPs also told us how their working environment can be lonely, with long hours spent seeing patients but without the opportunity to talk to colleagues.
‘The numbers of patients they see can be unsustainable, leaving GPs with too little time to catch up on other tasks. These pressures can also damage their relationships with patients, who sometimes feel they are being dealt with in a cursory way.
‘But there are examples of innovative best practise across the country. General practices are developing new roles and working in primary care teams to better support GPs, they’re designing services – with patients and communities – to ensure preventive healthcare, using technologies to manage demand, and developing healthier and more supportive environments for GPs and their staff.’
BMA council chair Dr. Chaand Nagpaul said the BMA welcomes the report and added that the Government has a ‘significant’ responsibility to invest in the NHS to alleviate the ‘unsustainable’ pressure on services.
He said: ‘Employers have a duty of care to ensure a healthy work environment and we would like to see the swift implementation of the BMA Mental Wellbeing Charter across the country to ensure a caring and supportive environment.
‘While medical schools and trusts have a key role to play, the Government has a significant responsibility to invest in the NHS to alleviate the unsustainable pressure on services which is pushing doctors beyond their limit.’
GMC chief executive Charlie Massey said: ‘Medicine has always been a high-pressure career, but doctors are telling us that the demands on them are now so great they risk becoming unmanageable. As a result, their own health suffers, and patient care is compromised.
‘Solutions are not easy, but this report shows that there are already many examples of great practice to build from. As a regulator, we will use all our influence and powers to support doctors and medical students.’