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GPs to be provided with occupational health support, after NHS England bows to demands

Exclusive All GPs will be provided with ‘high quality’ occupational health support if they need it, says NHS England in a significant victory for Pulse’s ‘Battling Burnout’ campaign highlighting the dangerous levels of stress and mental exhaustion in the profession.

The announcement came in NHS England’s official response to a letter sent by Pulse earlier this year – co-signed by 100 GPs – urging it to reconsider its ‘bafflingly short-sighted’ move to restrict occupational health support only to GPs when they had performance concerns raised.

It came hours before the LMCs Conference in York was about to debate a motion calling for the conference to ‘deplore the decision to no longer fund an occupational health service for GP practices, unless there is a performance issue’.

In the letter NHS England chair Professor Malcolm Grant recognised Pulse’s campaign and said the NHS could not afford to lose good GPs and that it would ‘play its part’ in ‘helping the profession deliver for patients’.

The GPC praised the ‘breakthrough’ and said that Pulse’s campaign had helped put more pressure on NHS England in negotiations.

An NHS England spokesperson told Pulse that it had taken a ‘step back’ from a previous announcement from NHS England in January that it intended to replace the current postcode lottery of occupational health provision – formerly provided by PCTs – with funding only for GPs ‘where there are concerns about performance’.

He said that NHS England had decided to procure a ‘high quality’ occupational health services that all GPs in England could access. Salaried GPs would also be covered by the service, but he said that practices would have to pay if any members of their staff – such as practice nurses or managers – used the service as employers.

Pulse’s Battling Burnout campaign ran the largest ever survey of GP burnout that showed over 40% of the profession at risk and publicised the issue in the national press. We also urged GPs to write to their local MP and sent NHS England chair Professor Grant a letter earlier this year deploring the body’s decision not to fund comprehensive support for stressed and burntout GPs, cosigned by the BMA, RCGP and over 100 individual GPs.

In his response to the letter, Professor Grant told Pulse: ‘GPs are the cornerstone of the NHS, providing an essential service in all our communities. It’s a hugely valued and important role but the demands can be intense. The role is set to become even more crucial because we need GPs to lead the transformation of primary care that we all want to see.

‘So we need good people to join the profession and to stay in the profession – we can’t lose them to burn out. I welcome Pulse’s work to improve the welfare of GPs. NHS England needs to listen with great care to what GPs are saying. We will play our part in helping the profession deliver for patients.’

Head of primary care development at NHS England, Dr David Geddes, a GP in York, explained that now it would fund an occupational health service that all GPs on the performers list across England could access – similar to the service offered to GPs in Wales.

He told Pulse: ‘We have taken a step back, thinking we need equity between the professions, and we need to ensure that what we do have is affordable. We will prioritise those that are on the national performers list: doctors, and dentists and optometrists, but not practice staff, not nurses. Not when they are employed by the practice.’

He added that the decision was made due to concerns over patient safety, although he denied that the change was a reversal of previous policy.

He said: ‘[Occupational health] is about making sure the doctor is safe to do their job, but also the job is safe for the doctor to do, that is a very important part of it. So it means that you don’t need to be burnt out to see our occupational health.’

Dr Geddes said that NHS England would now establish a procurement framework, ‘within the next four months or so’ that area teams will use to commission services that meet the national criteria.

He said: ‘As area teams’ contracts start to come up to expire we will offer that procurement framework so there will be a whole range of different providers who will all, if you like, meet the criteria of the service that we need to commission.’

GPC chair Dr Chaand Nagpaul said that the announcement was a ‘step forward’ for GPs. He said: ‘We are pleased that NHS England has understood that it is crucial that GPs, as well as all other staff in the NHS, should have access to occupational health services. That is a breakthrough. It is important they have recognised the need to resource this.’

He added: ‘We are still in dialogue, so we have not finalised any agreements. We’re still concerned that practice staff do not appear to be part of the poroposed scheme, and we think it is fundamental that practice staff and nurses…should be given the same treatment as other staff in the NHS.

‘We’re pleased after the pressure we have put on NHS England, they have come back to us with proposals. That is a step forward. We are certainly in a better place than we were last year.

‘It is really important that publicity through the Pulse burnout survey, as well as opinions expressed by GPs, is vitally important so that politicians realise it is not just GPC leaders saying this.’