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GP workload is a matter of life and death



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The LMCs Conference in Belfast last month, which determines the policy of the BMA GP Committee for the following year and therefore affects the whole profession, was a pretty staid affair.

GPC chair Dr Richard Vautrey’s speech was based on having ‘listened, acted and delivered’ in the four countries, especially in England on the new contract.

A number of speakers on stage referred to the first genuine sense of optimism they have experienced at any conference in recent years. Controversial motions criticising the primary care networks introduced by the contract and calling for a radical change in payments to reward activity rather than list size were abruptly shot down.

I know such optimism will surprise many grassroots GPs (and even some who attended the conference). The new contract in England does little to cut immediate workload, and there is no guarantee the shift to networks will turn general practice around.

But the conference was dominated by a speech by Dr Lucy Henshall, from Suffolk LMCs. She told everyone the tale of Richie, a friend of hers from medical school and her husband’s practice partner.

‘As a GP trainer, he inspired a generation,’ she said. ‘Astute clinician, compassionate, skilled, and a joy to work with.’ But she added: ‘General practice made Richie ill; he needed two lengthy spells off work for depression. A complaint landing just as he returned from a family holiday had changed him irreversibly.’

We do know that being a GP does not help people’s mental wellbeing

In December 2013, Richie died by suicide.

It would be irresponsible to assume a single cause for suicide. But we do know that being a GP doesn’t help people’s mental wellbeing.

Dr Henshall gave stark figures: one in three GPs suffers burnout, depression or both; female doctors have four times the suicide risk of the general population; and the average age of GPs accessing England’s GP Health Service is just 38.

We know complaints are not subsiding. The tendency of health managers to dump more work and blame on GPs continues, as our cover feature on antibiotic prescribing testifies (see page 6).

But most importantly, workload has continued to increase since Richie died.

We will be releasing the results of our workload survey next month and we will be taking action.

But we also want to see people with power step up. We know GPs are hard to find, but there are things that can be done. We want commissioners to be compelled to introduce measures to prevent GPs working above safe limits. We want them to actually implement the NHS standard contract, forcing trusts to offer a new referral instead of sending patients back to their GP, with more than a slap on the wrist for those that breach this.

I will not apologise for banging on about workload, because it is the overriding issue facing the profession.

Workload must the GPC’s priority for all four nations this year and the rationale behind any initiative. I fear the requirement to be registered as part of a network in just six weeks’ time, for example, would have to be halted if we applied this thinking (see page 14).

Because GP workload is a matter of life or death – and not just for patients. Until we’ve addressed this, any optimism must be tempered.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at editor@pulsetoday.co.uk