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GPs more likely to work 10-hour shifts at larger practices

GPs working in practices with larger patient list sizes are more likely to work longer clinical hours than those based in smaller practices, according to the results from Pulse’s major workload survey.

GP leaders said at smaller practices GPs were more likely to be familiar with patients – and could therefore offer better continuity of care, which avoided adding to workloads.

There has been a perception that health authorities are favouring upscaled practices, aided by the revelations in Pulse that the former NHS England medical director, Dr Arvind Madan, said GPs should be ‘pleased’ when small practices close.

Pulse’s survey revealed almost a third of GPs (31.6%) working in practices with 10,000 or more patients reported completing 10 or more hours of clinical work on the day of the snapshot survey, Monday 11 February.

At practices with 7-10,000 patients, 29% of GPs completed these longer hours, compared with 23.9% of GPs at practices with 3-7,000 patients, and just 12.5% at practices serving up to 3,000 patients.

Tower Hamlets LMC chair Dr Jackie Applebee said: ‘Governments across the UK are moving towards bigger practices through networks, clusters or federations. Yet the survey reveals GPs in larger practices are more likely to work long hours.

‘I work in a small practice and we all know the regular attenders and more complex patients. If a complex patient has to see a different GP each time, that might add to workload.’

Walsall LMC chair Dr Uzma Ahmad added: ‘On funding, the Government thinks it’s better for a bigger practice, but for patients, smaller practices provide more continuity of care.’

In response to Pulse’s workload survey, an NHS England spokesperson said: ‘We already know that general practice is under pressure which is why investment in local doctors and community services is increasing by £4.5billion, helping fund an army of 20,000 more staff to support GP practices as part of the NHS Long Term Plan.

‘But we are also aware that almost nine out of 10 salaried GPs currently work part time.’

Pulse’s survey findings are based on responses from 1,681 GPs about their day spent in practice on Monday 11 February.

The results showed more than half of GPs say they are working above safe limits, on average completing 11-hour days and dealing with a third more patients than they believe they should be seeing.