It’s true workload in general practice is exceptional by any objective measure. Our cover feature shows GPs are working, on average, 11 hours a day. In how many other professions is that the norm – other than those where earning vast sums is the driving force?
Yet the general public – after years of misleading headlines about GP pay – will lump GPs in with the investment bankers and City lawyers. The only way to drive home the message that drastic change is needed is by emphasising the danger to patients.
Because there is real danger. Facing a daily conveyor belt of patients makes it impossible for GPs to give each the best care they can.
There are the more tangible effects, like missing an important point in test results, failing to contact a patient who is awaiting a call or rushing a consultation that needs more time because there is a waiting room full of other patients who need care.
But there are also the intangibles, maybe best summed up by our cover quote: ‘There is a point where I feel cognitively drained and, after about 20 patients, there is not an iota of sympathy left.’
Facing a daily conveyor belt of patients makes it hard to offer each the best care
I am in awe of those of you who can engage with, say, 70 patients in a day, treat the last one as you did the first and summon the empathy needed to give each one the care they need.
But this takes a superhuman. GPs should not be expected to work at this level and the profession now needs to deliver a stark message about the risks to patients.
It’s true the BMA and the RCGP have used patient safety as a message in the past. But the profession needs to connect on an emotional level and change the narrative. Those tales of burnout still need to be told, like Nabi nearly crashing her car after a 14-hour day, or Dr Rich Bennett, whose relentless workload meant a single patient complaint contributed to the depression that led to his suicide.
But we need to make the public ask themselves: if this is what GPs are doing to themselves, are they really able to give me the best care?
Then hammer home the demands: no new work introduced in the contract without equivalent work being removed, with a full impact analysis of the time saved (a boast of £20m being put into the global sum that boils down to 90p more per patient no longer cuts it); anything that even looks like screening having to receive approval from the National Screening Committee; and campaigns to inform patients when they actually should see a GP about self-limiting illness.
In addition, no new guidelines are to be issued before taking proper account of workload implications. This approach would even allow us to call for the abolition of CQC inspections, with the public told the huge workload burden they entail is harming, rather than protecting, patient safety.
There’s a chance warnings around safety will erode trust in GPs, which remains high. But, as workload grows and GP numbers shrink, the risk to patient safety will no longer be just a risk.
Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at firstname.lastname@example.org