GP workload makes us weep, wheeze or explode

Copperfield laments the workload poured onto GPs, who must be ‘everything to everyone’

Do you mind if I cathart for a moment? Otherwise my head is literally going to explode in an eruption of cranial shards and cerebral blobs, and no one wants that.

Or do they? ‘They’ being the various agencies currently sending emails to our practice which could all be summarised as: ‘must try harder’. In the last week alone, we have received three:

1. A LES asking us to seek and destroy those with uncoded CKD, and to up our ACR/statin/ACEI game with existing patients.
2. Another LES wanting us to find more hypertensives, treat more hypertensives, treat hypertensives more, and various other iterations of the words hypertensive, treat, find and more.
3. A finger wag report informing us that we’re on the ‘dishing out SABAs’ naughty step. Apparently, our ideas should be bucked up and our SABA prescribing bucked down.

‘1’ and ‘2’ at least came with a grating of a LES carrot. But ‘3’ came only with a stick: a ‘requirement’ that our practice attends remedial teaching on structured asthma reviews. Highlighted as free, which is very generous, and also suggests they seriously considered asking us to pay for our own punishment.

If we all loved mandatory training and we’d all been desperately looking for more, I wouldn’t have blown my stack, but we don’t and we’re not, so I did. The insulting gall. And where in the contract etc etc…

Which was my first email reply. My second was a little more considered. It pointed out that various bodies inside and outside the ICS have their drums to bang. That the final common pathway for these is always the GP. That we GPs have to be everything to everybody. And that each initiative, each LES and each mandate has an opportunity cost which no one other than GPs seems able to appreciate.

Or to summarise emails ‘1’ and ‘2’, we don’t need training; we need headspace. Particularly given the current context, where GPs are having to block surgeries to create room to triage the online torrent mandated by the Government, thereby simultaneously improving access and restricting appointments. Result? You end up either weeping or exploding.

Or, in my case, catharting. Thanks for listening. I do feel less volcanic, though my stress-induced asthma is playing up. And oddly, I can’t find my SABA.

Dr Tony Copperfield is a GP in Essex