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‘Overwhelmed’ salaried GPs should consider workload boundaries, BMA suggests

‘Overwhelmed’ salaried GPs should consider workload boundaries, BMA suggests

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. 



Please note, only GPs are permitted to add comments to articles

Patrufini Duffy 21 October, 2022 4:06 pm

I think their boundary was “don’t be a Partner”. Or did we miss the memo.

Julia Visick 21 October, 2022 11:17 pm

What about GP Partners – the BMA doesn’t give a monkeys about them… many salaried GPS getting more income for hours worked than partners now… especially if their training and any additional roles are done within working hours. Don’t me wrong – I’m not saying this is a bad thing – but don’t all GPS need this ? At the moment it’s an uneven playing field and GP Partners have often done all they can to reduce workload. The only other option is for Partners to hand back the contract – then we could all be salaried/ have boundaries…. Oh hang on … that seems to be happening!!

Scottish GP 21 October, 2022 11:36 pm

Julia, we need concerted action as a profession to look at excessive workload. We are not allowed to kill employees but no law against killing ourselves. Sadly impossible to get GPs to think collectively, too interested in a few bob from latest initiatives. Our profits are in real terms half what they were 20 years ago, train drivers with their annual militancy now earn akin to a salaried GP. Nothing will change, cardies won’t have it. I am retraining 🚂

Turn out The Lights 23 October, 2022 11:08 am

BMA why do you think there is an exodus from partnerships.You have not set boundaries in the contract you have negotiated with the employer in a quasi communist monopoly.The exodus will continue boundaries need to be set for everyone.The contract is not fit for purpose.Unless you mean the collapse of the GP land and hence the NHS.

Wendy Harrison 24 October, 2022 11:38 am

And GP partners? Who do I talk to about my work load and being overwhelmed? Who cares about us?

A Non 24 October, 2022 7:04 pm

To all those moaning ‘what about partners’ ..the article isn’t about partners it’s about the salaried GPs you are employing. Most other articles are about partners and there are no end of partner’s comments on here, often moaning about how lazy and useless everyone else is, so give us a break hey and let this article be about someone else for a change

Donna Holt 24 November, 2022 4:36 pm

I went to my practice about my concerns and was told ‘we don’t offer a BMA contract’-so I’m handing in my notice tomorrow.