GP survey results hugely concerning

So, the results of our snap survey into the pressure GPs are facing are in and they do not make for encouraging reading. My thanks to the 669 of you who gave your time to respond. The fact is the results were worse than I expected and underline that general practice in Scotland is under immense workload pressure and something needs to be done.

Two out of every three GPs currently describe their workload as unmanageable, for some this was the case before the pandemic but for most this has been a change as we deal with the effects of managing primary health care in a pandemic, while continuing to respect the need for infection control measures with PPE, social distancing and remote triaging.

This rise in workload is having an adverse effect on GP physical and mental wellbeing with 73% reporting a negative impact. As a consequence, and in an attempt to protect yourselves, 70% consider they are more likely to seek early retirement or leave the profession and 66% are more likely to reduce the number of sessions they work.

These are very concerning figures for the GP workforce when you consider we started the pandemic substantially short of GPs and with a government plan to expand GP numbers in 2027 by 800. It seems possible we are going backwards in terms of building our workforce. Added to this, only 27% responding said they would definitely recommend working in general practice as a career, that is not encouraging for recruitment of the next generation of GPs Scotland will desperately need to deliver the National Clinical Strategy of a primary care led NHS.

Working hard for the benefit of patient care is what we expected when we entered medicine. The job brings its rewards, one of which is the grateful thanks of patients for caring and for at times going the extra mile and sometimes even putting ourselves at risk. That’s why a year ago during the first-wave of the Covid19 pandemic the evening public clapping as a thank you to NHS and care staff in its way made us feel like we were doing something that the public really appreciated. When we saw in the windows of houses pictures of rainbows drawn by children and the message ‘Thank-you NHS’ we knew how much people really cared for what we did. Fast-forward a year and contrast that with the survey result that showed that nearly 90% of GPs and practice staff had experienced abuse from patients during the last month. That is so disappointing. Of course it will only be a minority of patients who behave that way, but it remains unacceptable. We know that very often it is our reception staff who bear the brunt of such abuse when they are only trying to do their jobs properly. Being a GP receptionist is not an easy job; dealing at times with a large mismatch between demand and capacity, where they must attempt to assist in prioritising those patients with greatest need. We are all only human beings – doing our best in extremely difficult circumstances. No-one deserves to be the subject of abuse simply for doing their job – and I know it has a really debilitating effect on those on the receiving end.

To an extent of course, we have all been frustrated by the effect the pandemic has had on what we previously regarded as normal life and we all want to get back that life as soon as we can. The unacceptable abuse directed at those working in general practice is probably only the tip of the iceberg of dissatisfaction in the public mood. That’s where we need true leadership from both the new Cabinet Secretary for Health and Social Care and indeed the First Minister to reach out to the nation and recapture the mood that we are all in this together, that we must continue to prioritise our resources for those who have greatest health needs and that until we have completed our national recovery, people must understand that if they are told that other patients have greater need they must be willing to accept that on the understanding that if in turn their needs are greater they will be given that priority.

Indeed, there is no quick fix for the challenges GPs currently face – but there are some steps that can be taken now. We urgently need reassurance from the Scottish Government that General Practice will be adequately supported as we recover from this pandemic. GPs can only work within the limitations we have available to us right now and we need the Scottish Government, and indeed all politicians, to be clear and realistic in their messaging about just what is possible for GPs at the moment –  that the public must be patient and understanding and that abuse of health and social care staff trying to do their best in difficult circumstances is unacceptable. We need to step-up the pace of transformation to fully implement the 2018 GMS contract, including a renewed focus on recruitment of staff from across professions to work as part of practice teams; and finally we need national support for practice Protected Learning Time for GPs and their staff to reflect on the changes brought about by the pandemic, and for planning and recovery of their services going forward.

Looking longer term;  as I have already highlighted, Scotland was promised 800 additional GPs by 2027, we need the new Health Secretary and Scottish Government to redouble efforts on this, establish a clear understanding of what workforce we have now and how plans to increase the number of GPs will be achieved as part of a comprehensive workforce plan.

Of course, things are tough now – but I do remain convinced that with some positive steps we can come through it. I know we are proud to be GPs and at its best, this is a wonderful and immensely satisfying career, making a real difference to potentially hundreds of lives. If you are suffering right now, the BMA are here to help – or do please get in touch with the new Workforce Specialist Service – which the BMA lobbied hard for and will provide targeted support for GPs suffering with their mental health.

BACKGROUND:

You can find full details of the specialist service here. If you do need to use it, please complete both the registration forms and wellbeing questionnaires available HERE – it is essential that you complete both sets of forms to register for the service and ensure you are provided with the support you need. If you have any difficulties accessing or completing the forms, or would prefer to speak to someone in the service please call 0300 0303 300. (Monday – Friday 8am-8pm, Sat 8-2pm).

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