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Burnt out GPs denied occupational health support in NHS England U-turn over pledge to retain services

Exclusive: An NHS England local area team has pulled funding from an occupational health service for stressed and burnt out GPs despite NHS England promising to continue paying for PCT legacy services while it conducts a national review, Pulse can reveal.

GPs in Cleveland are now being refused funding for occupational health support unless their performance is under formal review, in contrast to the previous policy under the PCT. Providing support only to GPs whose performance has triggered a formal review comes ‘too late’ to help many suffering from mental exhaustion and stress, GP leaders have warned.

NHS England told Pulse in July that it had written in May to its local area teams instructing them to ‘refrain from creating interim policies and retain the historic PCT position’ pending the results of a nationwide review into occupational health funding due this month.

But Cleveland LMC has warned that its local occupational health service has been refused funding that it would have received under the former PCT and that support is now only being funded for GPs who accessed the service before April, or those with specific performance-related concerns.

Pulse revealed last week that almost 10% of GPs have had to take time off work due to stress, as the pressure on occupational health services grows. Pulse has been lobbying for better monitoring of GP workload and more nationally consistent occupational health support for GPs as part of our Battling Burnout campaign.

NHS England’s Durham, Darlington and Tees local area team told Pulse the funding of occupational health services had changed because the former PCT’s budget had been ‘redistributed’ and that it was waiting for national guidance to be developed.

A spokesperson said: ‘When area teams took over from primary care teams on 1 April 2013, funding for occupational health services changed.’

‘Before 1 April 2013 there was a mixed economy in that some PCTs paid for all occupational health support to primary care practitioners and their practices and some did not so the situation was inequitable.’

‘The former Durham, Darlington and Tees PCTs paid for occupational health services through their corporate budgets. Such budgets have been redistributed as part of a national formula-based running costs/management costs allocation process. As such there will no specific like-for-like mapping of this funding.’

‘We are still waiting for the final position from NHS England on the matter of funding occupational health services for all primary care contractors. At present, Durham, Darlington and Tees area team only pay for occupational health matters related to professional performance concerns that they commission.’

But GPC representative Dr Bill Beeby, who is a member of Cleveland LMC and a GP in Middlesbrough, warned that only offering support when a performance problem had flagged up was leaving it ‘too late’.

He said: ‘The service, as provided before, was confidential, accessed by a number of people - not huge numbers, but people who felt they were losing control - and before it all went completely off the rails they sought this help in confidence. Hopefully a large number of them would have been prevented from going over the edge.’

‘The problem is, when it becomes a performance issue […] it’s already too late, the stress has gone beyond that limit. What was simple counselling becomes something far more complicated, and something far more threatening to your livelihood. Because now, you’re out of work and no longer keeping up to date. It’s much more difficult to get back in than it ever was to stay in.’

GPC negotiator Dr Dean Marshall said the GPC was ‘extremely unhappy’ that occupational health services in a number of areas were coming under pressure.

‘Occupational health is an important service for GPs, and it’s another example of where people are looking at the cost of things, rather than the value of things. It’s extremely valuable to provide that kind of service to GPs and we’re aware that there is a move in quite a few areas of the country to remove it.’

A spokesperson for NHS England nationally said: ‘The priority for NHS England is to commission an effective, accessible occupational health assessment when necessary for any GP, dentist or optometrist on the performer list where a potential need arises.

‘This would include for those doctors whose health may become a factor in how effectively they can deliver services.’