GPs are working 11-hour days and dealing with an average of 37 patients in that time – far more than the 28 patients they believe is the safe daily limit in the pandemic, a major survey has revealed.
Pulse’s snapshot survey of 1,400 UK GPs, which took place on Monday 1 March 2021, revealed 69% of GPs’ patients were either ‘very’ (29%) or ‘fairly’ (40%) complex.
Over half of GPs said consultation time is now ‘significantly’ (24%) or ‘slightly’ (31%) longer than before the pandemic.
It comes after the Covid-19 outbreak forced GPs to change the way they work, by providing far more remote consultations – often taking more time. They also have to put on and take off PPE and clean rooms in between face-to-face consults.
Overall, around half of GPs said their level of work was unsafe on the day of the survey – and 70% said in general daily workload now was ‘significantly’ (35%) or ‘slightly’ (35%) higher than on a typical day before the pandemic.
GP leaders said the findings showed how ‘incredibly hard’ the profession had been working throughout the pandemic, but warned ‘there is only so far they can stretch themselves before they reach breaking point’.
The results show workload levels are as high as Pulse’s first survey found two years ago in 2019, in which GPs revealed they were working 11-hour days, including eight hours of clinical appointments.
Wirral GP Dr Albert Pereira, who took part in the survey, said: ‘There is more multitasking now, reading e-consultation forms first then phoning the patient, waiting for an answer.’
Another survey respondent, Berkshire GP Dr Chauke Kade warned patients are increasingly ‘consulting by email’, rather than using official e-consultation forms, meaning there’s a risk the messages will be missed.
He said: ‘They are using the practice’s generic email and asking admin staff to forward their email to their doctor. This is a safety issue. We do not access our emails daily.’
Bristol-based portfolio GP Dr Harry Minas said the lack of physical contact with patients posed a risk to understanding symptoms: ‘We miss the body language element of the communication, which can be as much as 80% of what both parties see and use to make decisions.’
Aside from GPs providing care to their usual patients – many of whom held off seeking medical help in the initial months of the pandemic and have now deteriorated – GPs have additional pressures from running the Covid vaccination programme.
Recent NHS England board papers revealed that, when Covid vaccinations are also taken into account, practices delivered one million more GP appointments per week in January then before the pandemic – a 15% increase.
Kent LMC medical director Dr Andy Parkin said: ‘A lot of practices are finding it hard to manage the vaccination workload, the increasing day-to-day work and patient expectations of being able to contact their GP remotely whenever they want.’
GPs have faced frustrated patients who believe practices have not been open, due to the switch to more remote consultations and a barrage of media reports suggesting GPs were closed.
Pulse’s survey found 40% of GPs have had either ‘significantly’ (16%) or ‘slightly’(24%) more complaints in the pandemic.
RCGP chair Professor Martin Marshall said GPs’ services have ‘remained available’ and ‘exceptionally busy’ during the pandemic.
He said: ‘These survey results show how incredibly hard GPs and our teams are working, and have been throughout the pandemic.’
Professor Marshall added: ‘The College has been raising concerns about the workforce and workload pressures facing general practice – and the need for them to be addressed – for some time. The pandemic has only exacerbated these pressures. GPs and our teams continue to work long days – well above their “normal” hours – as they strive to deliver the care patients need, as well as all their other responsibilities.’
BMA GP Committee chair Dr Richard Vautrey said: ‘As we move beyond the crisis stage of this winter wave, GPs will continue to face intense pressures and we must ensure all in the general practice workforce are given time to rest and recharge before autumn.
‘Not only will we have the annual flu programme alongside any further Covid vaccination boosters required, we will also need to address the huge backlog of care while there is the potential for further spikes in coronavirus infections.’
He added: ‘And while [GPs] have gone the extra mile for their patients throughout the pandemic, there is only so far they can stretch themselves before they reach breaking point.’
An NHS England spokesperson said: ‘In recognition of challenges that GPs, like all NHS staff, have faced with Covid-19, and to help alleviate some of the pressures in general practice, we have provided a number of financial and practical measures to support practices and staff which includes coaching and mentoring, additional financial support for clinical directors and £150m to expand general practice capacity during the pandemic.’