GPs are facing ‘moral distress’ as a result of not being able to deliver the care they feel they should – including due to remote consultations – a BMA report has revealed.
A BMA survey of more than 1,900 UK doctors – 22% of whom were GPs – conducted from March to April 2021 found that 75% of GPs had experienced ‘moral distress’ at work.
The report found that:
- 51% of GPs reported ‘lack of time to give sufficient emotional support to patients’ as one of the top five causes of moral distress, defined as psychological unease when a professional cannot act in what they deem the ethically correct way due to constraints outside their control, such as insufficient staff, resources or time.;
- 48% chose ‘insufficient staff to suitably treat all patients’ as one of the top five causes of moral distress;
- More than four in ten (44%) GPs also reported that ‘moral injury’ resonated with their experience at work – defined as longer-term psychological harm from sustained moral distress, which can lead to severe mental health issues such as depression or post traumatic stress disorder (PTSD).
It stressed that moral distress is not limited to those working on Covid wards, and that GPs too have faced it due to not being able to see their patients face-to-face or having to manage those stuck in the pandemic backlog.
The report said: ‘It is important to recognise that Covid-19 has not just caused moral distress in those directly dealing with Covid-19 patients.
‘Those who have not been able to see their patients directly, limited for example to telephone consultations, or the de-prioritisation of certain patients could lead to moral distress in those not directly dealing with Covid-19 patients, such as GPs’.
But GPs were also most likely to report having experienced moral distress prior to the pandemic, with 67% reporting this compared with 57% of both consultants and junior doctors, the report said.
One anonymous GP respondent told the BMA: ‘I’m very aware that under normal circumstances I could’ve done a lot better, I’m frustrated that the personalised care that I value so much has been wiped out in a sea of demand and different ways of working and I just want all this to end and go back to normal, but I do not see that coming, at least not in the working life that I have left.
‘In January this year I had a particular low point and just wanted to leave to escape the unpleasantness, sheer exhaustion and the long winter.’
Meanwhile, the report also revealed the impact of the challenges GPs have faced on their future plans.
When asked how they have changed their plans for the next year:
- 56% of GPs said they were ‘more likely to take early retirement’
- 32% said they were ‘more likely to leave the NHS/HSCNI for another career’
- 33% were ‘more likely to take a career break‘
- And 25% were ‘more likely to work as a locum’
BMA GP Committee chair Dr Richard Vautrey told Pulse: ‘This research is very alarming but also very important as it shines a light on the extent of the struggles that GPs and doctors across the NHS are experiencing due to the constraints of not being able to provide the care they would like.
‘GPs by their very nature have got into this profession to care and help patients which is what they spent years of training to do. Clearly the serious staffing shortages, years of underinvestment and the demands of the pandemic have taken their toll on GPs and their ability to provide the care they would like to.’
The Government must ‘take this research seriously’ and action the report’s recommendations so that GPs are ‘better protected and can get on with what they want to do most – care for their patients’, Dr Vautrey added.
The BMA has developed a set of recommendations stemming from the report’s findings, including structural solutions such as increased investment and staffing and personal steps that doctors can take such as developing peer support groups, seeking advice and developing a ‘self-care plan’.
GPs are facing increasing pressure from patients demanding services return to ‘normal’, with some last week telling Pulse that their practices have received abuse from patients as a direct result of NHS England’s face-to-face order.