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Pulse 2019 review: GP workload laid bare

It’s not news that GPs are stretched. But the extent to which their excessive workloads impact their own mental health and patient safety was unveiled this year, in Pulse’s first ever workload survey.

The survey was conducted over a single day – Monday 11 February – in an attempt to get a snapshot of what the typical working day is like for GPs.

Nearly 1,700 GPs took part either by submitting responses online, or by sharing their day on social media. They described the unyielding pressures they face daily, revealing that many feel they are working in unsafe conditions.

On average, GPs work 11-hour days, eight of which are spent delivering clinical care. They think a safe limit of patient contacts per day is 30, yet in reality, the average is 40.

The picture was accurately summed up by some GPs who got in touch with stories from their overworked colleagues who were too busy to respond themselves.

Despite estimating a safe daily limit of patient contacts as 30, as many as 10% of respondents reported having double that on that February day, which they said was typical.

Survey respondents said they’d had a mix of face-to-face, phone and online consultations and reported that one-third (33%) of cases were either ‘very complex’ or ‘fairly complex’.

More alarming than the statistics was the deluge of anecdotes, many of which are nothing short of heart-breaking.

‘There is a point where I feel cognitively drained; after about 20 patients, there is not an iota of empathy left,’ said one Hertfordshire GP, who described feeling ‘mentally and physically exhausted and more likely to give in to patients’ demands’.

This pressure not only shakes one’s confidence in patient care, the GP said, but ‘affects your home life too’.

Another GP said the risk to patients escalated throughout the busy day and that, by lunchtime, he ‘felt on the edge and risked missing urgent tasks… thus affecting patient safety’.

The causes of growing workloads are widely known. Too few GPs, practice closures and increasing patient demand create a strain. Hairbrained government plans – like advising patients to see their GP if they don’t know their blood pressure – add to it.

The incumbent health secretary Matt Hancock later promised to field some of the additional appointments this would inevitably generate with 6,000 new GPs by 2024-25.

If that doesn’t spread the workload, GPs could follow the example of their Spanish peers, who took to the streets of Catalonia in a week-long protest at their high patient numbers and unfavourable working conditions.

One thing’s for certain: the status quo is unsustainable. One GP sadly paid the ultimate price for being stretched beyond his limit this year – and that’s one too many.