During recent years, there has been a widespread and shared belief, amongst many GPs and others working in Primary Care that workloads have increased exponentially. The Government has failed to resource adequately for this and, as such, not only is this having an impact on the health and wellbeing of GPs, it is also at times affecting their ability to provide safe and consistent levels of care.
It is now commonplace for the media to sensationalise issues occurring within Primary Care concerning the supply and demand of services and the impact that this has on other frontline services. Most GPs want the best for their patients and, as such, the increase in workloads has been raised repeatedly and consistently with the Government, only for these concerns to be rebuffed, by both NHS England and the Department of Health, with promises of thousands of extra staff in Primary Care by 2020.
Despite the attractiveness of thousands of more staff in 2020, a new study in the Lancet led by researchers from the BMA and the Royal College of GP’s, provides clear objective evidence of what GPs have been saying for years and demonstrates that action must be taken now.
The key messages from the study, which covered over 100 million GP and Nurse Consultations at 398 practices in England during 2007 and 2014, include:
– ‘There is a substantial increase in practice consultation rates, the average duration of the consultations being given and the total patient-facing clinical workload.
– GPs are facilitating more consultations than ever before for patients who are living longer, who often have multiple long-term conditions resulting in a complex presentations of symptoms that cannot be dealt with in the previously allocated time.
– Due to the change in nature and volume of workloads, GP practices and their teams are working harder than ever before, but struggle to provide basic levels of care as services are overwhelmed.’
The impact of inaction in the face of such significant objective data could be disastrous not only for staff but for patients also. With many GPs now facing the prospect of burnout or feeling the impact of being overworked, over tired and exhausted the results could be damaging for patients especially if this results in substandard care, harm or misdiagnosis.
Compounding these issues are figures released from Health Education England, who have revealed that one third of GP training places still remain vacant. Despite this representing a 1% increase on last year’s figures these results are second lowest recruitment results of all the specialities. This is not unsurprising as in 2015; GPs in England reported having the lowest job satisfaction rates since records began in 2001.
The solution for many of the problems reported across the NHS, according to the Government, is a greater shift towards ‘place based care’, a new model being explored to reduce the burden on the acute care system. However, without a serious focus on patients’ and communities abilities to self-care and make the most of non-traditional services, such as the extended pharmacy offer, the ‘place-based model’ will only once again serve to shift the burden from acute to primary care and resulting in further pressure to under-resourced and overworked GPs, and once again endanger the whole system of collapse.