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Relieve GP pressure, says GMC amid rise in trainer burnout


BMA and RCGP workload guidance


The GMC has raised concerns about pandemic pressures on general practice, after its annual training survey revealed an increase in burnout among GP trainers.

GPs cannot be expected to carry on working at this level of intensity and their wellbeing must be ‘central’ to the Covid recovery, the regulator’s chief executive Charlie Massey said in response.

The regulator’s annual training survey, published today, was completed by more than 63,000 UK doctors, all of whom were either trainees or trainers, with this year’s report covering the pandemic-hit 2019/20.

They survey saw 22% of GP trainers reporting that they felt burnt out to a high or very high degree because of their work, a five percentage point increase on last year.

It also showed that:

  • Seven in 10 (71%) GP trainers soften feel worn out at the end of the day, up seven percentage points on the previous year;
  • Just under a third of GP trainers (30%) feel frustrated by their work to a high or a very high degree, up five percentage points;
  • Over half of GP trainers (55%) feel their work is ’emotionally exhausting’ to a high or very high degree, with a further 37% saying it is ‘somewhat’ emotionally exhausting.

The GMC survey also saw a ‘swing’ towards more negative responses from trainees in this year’s survey, it said.

Using a seven-question model, it calculated an overall ‘risk of burnout’ for trainers and trainees alike.

This found that the proportion of GP trainees at risk of burnout went up from 7% to 13% over the past year, while among GP trainers, the figure rose from 9% to 13%.

Mr Massey said the fact that so many GP trainers and trainees were describing their work as ‘exhausting, that they feel burnt out and worn out, is worrying’.

And, he said that although it did not come as a surprise ‘we cannot expect doctors to continue to operate at this level of intensity’.

He continued: ‘The pressures on primary care services, and the toll they are taking on GP trainers, is a particular concern.’

‘The danger is that, unless action is taken, workloads and wellbeing will continue to suffer, and future burnout rates could get even worse.

‘As we move on from the pandemic, it is vital that doctors’ training and wellbeing needs are central to service recovery plans. This year’s results should be a blip caused by Covid, not part of a new normal.’

Mr Massey added: ‘These pressures are unlikely to ease any time soon, even once we reach the end of the pandemic.

‘GP trainers, like all doctors, need support to help them cope with their workloads.’

On the upside, 96% of GP trainers are satisfied that their working environment is supportive and 94% of trainers feel valued by their practice.

And around three-quarters (76%) of all trainees (across all seven specialisms) rated the quality of teaching as ‘good’ or ‘very good’, and almost nine in ten (88%) described their clinical supervision as ‘good’ or ‘very good’.

However, on in ten trainees, which the GMC described as a ‘substantial number’, said they were concerned about progressing through their training. Some 81% said they were on course to meet their curriculum outcomes for the year.

In October last year, Pulse reported that over two thirds of GP trainers had their roles disrupted due to the pandemic, and 91% said it had reduced the number of opportunities for their trainees.

Mr Massey concluded: ‘The overwhelming majority of GP trainers tell us they are satisfied they are in supportive working environments, which bodes well, but we cannot be complacent that things will simply return to normal.’

BMA GP committee chair Dr Richard Vautrey said: ‘It’s positive to see that trainees continue to rate their training and supervision highly, but what is incredibly concerning is the large increase in GP trainers suffering from burnout, with the same group most likely to say their work was emotionally exhausting and others frustrated that there are simply not enough hours in the day to give training the attention it deserves.

‘While this is testament to the dedication and importance GP trainers place in ensuring the next generation of GPs get the supervision and mentoring they need, it also underlines the intense and often unsustainable pressure being placed on individual doctors as they try to balance caring for patients, assisting colleagues and looking after their own wellbeing – often while managing the day-to-day demands of running a practice too.

‘A renewed effort to protect staff’s wellbeing, while providing practices with the resources they need to meet the growing list of demands they face, will be key as we face the next daunting stage of the pandemic and recovery.’

RCGP chair Professor Martin Marshall said: ‘GPs have been working incredibly hard during the pandemic under intense workload and workforce pressures, and this is understandably taking its toll on GP trainees and their trainers, as this survey shows.

He added: ‘A lot of great work has gone into increasing trainee numbers in general practice and we don’t want to see this progress regress. This is why we urgently need to see government address the workload pressures facing the profession by delivering on their manifesto pledge of an additional 6,000 GPs to enter the workforce by 2024, as well as initiatives in place to prevent experienced GPs from burning out due to heavy workloads.

‘This will help to ensure GP trainers have the time that they need to spend with trainees, and that trainees feel supported.’

Former RCGP chair Professor Dame Clare Gerada said: ‘The past year has undeniably been awful and most healthcare professionals are exhausted. We’ve had more present to mental health services in this pandemic year than in the last 10 years previous.’

Professor Gerada, who is the medical director for the NHS Practitioner Health Programme (PHP), continued: ‘These pressures are clearly still ongoing, and we need to get it sorted.

‘For GPs, no amount of resilience training is going to fix this problem, we just need more staff helping.’

Her comments come as in 2015, then GMC chair Professor Terence Stephenson had suggested that GPs needed training like soldiers heading for Afghanistan to boost their resilience.

Professor Gerada, who last month suggested that GP patient lists should be pooled across PCNs as part of measures to address the GP workload crisis, added: ‘There are ways of fixing this situation, but it is stacked against GPs at the moment and we need changes.’

Her comments come 22% more GPs are presenting to the NHS practitioner mental health service compared with before the pandemic, as revealed by Pulse in April.

READERS' COMMENTS [13]

John Graham Munro 27 July, 2021 1:15 am

However did we manage in the good old days without Trainers and Trainees?

Dr N 27 July, 2021 9:53 am

John – with Streptomycin, embrocations and leeches. We have moved on a bit since 1968

David Church 27 July, 2021 10:37 am

let’s see, 13% ‘at risk of burnout’, plus 22% already burnt out, means 35 % trainers need to stop being trainers?
where will all the non-burnt-out Trainees go to learn then?
Are we perhaps heading for a bit of a staffing crisis in GP-land?

John Graham Munro 27 July, 2021 12:32 pm

Dr N——-Ah!—–the time I wrote prescriptions in Latin—–examined a patient instead of going straight to a scan——-leaving my door open all day for the worried who felt better after coming in for a chat——- the only stress was the chemist often running out of leeches

Patrufini Duffy 27 July, 2021 12:35 pm

There is another PhD waiting for a research article and SMART learning points from: <>.

Patrufini Duffy 27 July, 2021 12:36 pm

The correlation between GP morale and NHS referral rates and discontinuity.

Turn out The Lights 27 July, 2021 4:12 pm

A lot of us have made decisions that will be enacted over the near future, nothing will stop those now are the GMC worried about losing all those subs that pay for them(or a decent chunk).?Crocodile tears?

A non 27 July, 2021 7:30 pm

John Graham Munro is a serial troll ..don’t feed him ..oooops just did

terry sullivan 28 July, 2021 11:21 am

snowflakes

Christine AMBURY 29 July, 2021 10:42 am

Equating patients to vermin in unacceptable and offensive in the extreme.

John Graham Munro 29 July, 2021 2:41 pm

Patients can be exasperating and more beside—— but not even ”I” who dislikes a lot of them would use that ‘V’ word

Andrew Jackson 29 July, 2021 5:32 pm

another canary in the mine warning
they are currently coming from every avenue but we are still waiting for a change that makes any difference