It’s the slow grind of general practice that wears us down

The hardest part of being a GP isn’t the patients; it’s the never-ending admin and bureaucracy, says Dr David Turner

‘How do you break the news to someone they have cancer? That must be terrible. I couldn’t do that.’

It is not uncommon for non-medics to make such comments about what they perceive as the stressful parts of our work. But, I think that most GPs would agree it is actually the day-to-day petty annoyances and tedious bureaucracy with which we are forced to engage that push most of us to the brink.

I’ll paint the scene.

You get to work a bit late. This is because, despite the fact that since Covid more people are supposed to be working from home, somehow the journey time to work has doubled. All you want is to turn your computer on and start work. But no. This is the day the system needs to update. Five minutes later you minimise a dozen pop up boxes asking you questions you cannot even understand, never mind answer. Finally, you get to your patient list.

First patient in the door is straightforward enough. They just need some routine blood test forms printed. You reflect to yourself in this ‘digital age’ you print more than ever. You press print and of course the printer is not working. Why, in the age when apparently AI is advanced enough to do most of our jobs, nobody seems able to make a reliable printer.

The morning progresses and involves several referrals. This entails some tedious form filling, asking a series of questions of no relevance to the clinical problem and at the end you know there is a pretty good chance the hospital will reject the referral in any case.

Lunchtime at last, and it’s time to catch up on blood test reports and prescribing while eating at your desk. Predictably this is the time your smart card decides to malfunction, meaning all the prescriptions need to be printed and manually signed. So much for the paperless age.

Hospital reports next. Most of which are either lists of jobs the hospital should have done but for some reason think it is appropriate to pass on to you. To spice it up a bit there will of course be a healthy smattering of outright hospital rejections, which will lead to a series of difficult conversations with angry patients, who are never really convinced that it is not the GP’s fault their referral has bounced.

A rarity arrives: half an hour to catch up with PDP. You click on to the mandatory training portal and are met with a rash of red dots, indicating outstanding training you must complete – in everything, it seems, from to how to safely store cleaning products to what to do should the surgery be invaded by a plague of locusts. Too overwhelmed by it all, you close it down.

Then, joy of joy, you remember your appraisal is due soon. Better write it up. What challenges have you faced in the last year? You feel like typing: ‘See last year’s entries but multiply by 10’, but think better of it at the thought police might be reading this. Got to think up three things for PDP for next year. You wonder, am I allowed to write ‘stop engaging with time-wasting bureaucracy?’ as one of them.

Oh God, emails! You almost forgot. 10 minutes left until evening surgery. You open your emails. Too many new ones to count. You skim them. Cyber alerts, drug alerts, some incomprehensible gibberish from NHSE, announcements about online courses, updates on gender reassignment and ADHD, safeguarding requests, patient feedback reports, changes to screening programmes, announcements about upcoming vaccination programmes. And these are just today’s emails.

No time left. Evening surgery waits and the waiting room is filling up. You reminisce about the old days and how before digitalisation, the toughest part about the job was what were known as ‘heartsink’ patients. You reflect that a waiting room full of heartsinks would be a walk in the park compared to the slag heap of unprocessed admin and bureaucracy perpetually teetering over you.

Oh well, time to crack on, call the first patient… ping: a news announcement on your phone. Apparently 55,000 patients nationally will need further blood tests after being wrongly diagnosed with diabetes due to a lab error.

And who will bear that brunt I dare wonder?

Dr David Turner is a GP in Hertfordshire