The BMA sessional GPs committee has suggested that salaried GPs feeling ‘overwhelmed’ should have ‘conversations’ with their employers about work above their contracted hours.
In an article shared on the BMA website this week, sessional GPs committee member Dr Paula Wright said that salaried GPs should consider what factors are placing their wellbeing ‘at risk’ and what ‘active steps’ they can take to look after themselves.
She said they should ‘talk to [their] employer about workload, on-call commitments and informal discussions if [they] are feeling overwhelmed’.
Dr Wright set out suggested steps that salaried GPs should ‘consider’, including having ‘conversations’ with their employers about workloads that exceed their contracted hours.
GPs should complete a ‘work diary’ to monitor their ‘actual hours’, which they will soon be able to do with a new app called Dr Diary, she said.
She added: ‘If this exceeds your contracted hours, discuss this with your employer with a view to backdated remuneration and an amended job plan going forward which is consistent with your contract.
‘Only when the overtime is priced in terms of pay will employers see the opportunity cost of inefficient working practices like using clinicians to do work which could be done by non-clinicians or other clinicians, such as document management’.
Salaried GPs could ‘consider doing this as a group exercise with colleagues’, she said.
Dr Wright also said that GPs can ‘discuss prioritising which activities within your work take priority and which you will cease to do until the employer has reassigned some of the excess work to another member of staff’.
This could include ‘incoming document management which admin staff can be trained up to do, completion of private medical reports, supervision or teaching of students or trainees, medicines alignment for discharges which could be delegated to a pharmacist’, she added.
Other steps that salaried GPs should consider included:
- Asking their employer to ‘reduce or drop’ their on-call commitment, increase appointment length or reduce contacts ‘before walking away’
- Whether their employer is ‘fully utilising’ locum cover for absences or whether this is causing them ‘excess workload’ with ‘prolonged hours or unsafe intensity’
- Whether they are ‘contractually required’ to provide absence cover ‘beyond the immediate emergency’ of 24-48 hours
- Whether the practice’s appointment system allows them to follow up on their own patients, which is ‘important not just for safety and doctor and patient satisfaction but also is protective against burnout’
- Whether there are opportunities to join in with ‘informal gatherings and discussion within the practice’ or the ‘work intensity’ prevents this
- Whether their job plan includes ‘mentoring or supervision which is not being offered’
Dr Wright said: ‘Factors that can contribute to burnout include working in excess of contracted hours such that your personal boundaries (work-life balance) are not respected (especially with unpredictable finish times), working within contracted hours but at high intensity and feeling unsafe, and working in isolation and at the limits of your experience or confidence without support.’
She added: ‘Only too often salaried GPs will walk away from a job because they feel they cannot cope and cannot change the job.
‘Once there has been an exodus, then the practice rethinks its approach to its salaried GPs. Is there a better way to avoid this cycle of repeat attempts at recruitment and failed retention?’
This week, a Twitter campaign revealed that some GPs are seeing hundreds of patient contacts in a day despite the recommended safe working limit of 25.
And earlier this month, the BMA issued updated safe working guidance which suggested that GP practices move to a ‘waiting list system’ based on clinical need to try and mitigate the current pressures.