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Patient safety at risk unless NHS creates ‘right working environment for GPs’

Burnout in doctors results in an increase in medical errors, reduced quality of patient care, and lower patient satisfaction, researchers have found. 

The analysis by researchers from the universities of Manchester, Keele and Southampton, yet to be published, concludes that ‘patient safety could be at risk’ unless the structural reasons behind burnout are tackled. 

Pulse has previously reported that GP burnout is continuing to increase, while NHS England has set up a service to support burnt out GPs.

However, the researchers said that stress management programmes are less effective than changing GPs’ working environment. 

The study looked at data from 42 previous studies to analyse associations between distress in physicians in the US and three core outcomes of patient safety incidents, poor quality of care and patient satisfaction.

The main analyses were based on 3,332 physicians from primary care, hospital and specialist areas. But researchers then focused specifically on primary care doctors and found the results were exactly the same.

Dr Maria Panagioti, lead author of the study and senior research fellow in health services and primary care at the University of Manchester, warned that the impact of burn out on patient safety and as an organisational problem has ‘not received much attention up to now’ and more research is needed in these ‘two key areas’.

She said: ‘The message from these findings is clear. If we want to retain safe and professionally competent NHS doctors in the very demanding UK primary care environment, we need to support their mental and physical health by creating the right working environment for them.

‘Efforts need to be focused on finding appropriate ways of reaching doctors who work in stressful environments to ensure their wellbeing is taken care of. If we don’t patient safety could be at risk.’

It follows the team’s previous research, published in the Journal of the American Medical Association, which analysed data from 1550 doctors to show that organisation-directed measures targeting the working environment are more effective at reducing burnout than interventions that target individuals, such as stress management programmes and mindfulness.

Maria Panagioti added: ‘In the UK many GPs have said that excessive work demands and system pressure is the main cause of their prolonged stress.

‘Organisation-wide initiatives for fostering communications between members of the health care team, and cultivating a sense of teamwork and job control are likely to be the most effective approaches in reducing burnout.’

Pulse’s Battling Burnout campaign led to NHS England providing substantial funding for a new national service to support GPs’ mental health, as part of the General Practice Five Year View.

In the first four months since its launch in January, over 500 GPs suffering from conditions such as anxiety, depression and post-traumatic stress disorder, had sought help under the new NHS programme.

Dr Panagioti said: ‘The new national GP service is definitely a positive initiative but it is too early to evaluate its potential benefits.’