Workload pressures affect GP mental health

GPs are coping with a lot of pressure and increasing risks to their mental wellbeing. The pandemic has all but brought some surgeries to their knees – some have even closed during the last 15 months. Statistics already show that some GPs have felt the need to give up their practice due to the stresses and strains of the General Practice workload. 

The additional pressures incurred over the course of the pandemic have affected an overwhelming amount of primary care staff. Many GPs have split their time between their own surgery requirements such as urgent appointments, remote consultations and essential paperwork, to working on the frontline, helping out at neighbouring practices and spending shifts administering vaccines. 

There have been shortages in surgeries, increased sick leave and pressure from the government to resume ‘normal duties’ virtually immediately, such as face-to-face appointments. The BMA report that there has already been an incredible surge of appointments in the last month or so at just under 3 million. This is without the directive to increase one on one consultations. Face-to-face appointments have steadily increased since 2015, with March 2021 being the highest ever month. 

Face-to face appointments

GPs have a duty of care to protect all patients and provide the best clinically safe environment for this to happen. Whilst COVID is still in existence, with new variants appearing, this is a difficult task. 

Just as the public are receiving confusing communications from the government in terms of holiday travel and ‘red lists’, GPs have been receiving mixed government guidance in regards to their practice. Only a few weeks ago, Matt Hancock, Health Secretary, stated that the system of telephone appointments has proved so successful that it will be his recommendation that this continues. In a turn about face, the government is now asking that face-to-face shifts be offered to all patients. 

During COVID-19, overwhelmed surgeries were encouraged to follow a majority triage model and replace most face-to-face appointments with video and telephone consultations, or indeed referring them to other services such as 111. The steady return to face-to-face appointments has been largely positive for patient-first care. Some patients are unable to fill in forms online, feel uncomfortable speaking about their health concerns over the phone or even trust the information given to them by a medical professional that they do not know. It can also make a difference when there are more subtle physical signs to look out for. 

Some GPs have found the instruction that they must offer face-to-face appointments for every single patient to be patronising and out of touch with their everyday practice. It could put more pressure on an already overworked medical force and GPs may struggle to see all the patients who need their help.

GP mental health 

Most reliable sources of information regarding GP mental health such as the BMA, report an unprecedented surge of around 30% of our practising GPs suffering some degree of stress or anxiety. Whilst they continue to work hard to offer the very best to their patients, there are other considerations, such as their own health and the concern for their families. After all, domestic life counts to them as much as anyone.  

Long hours, extra shifts at other surgeries or vaccination venues have taken up a considerable amount of both physical and mental energy.  With mental health being at the forefront of concern due to the increase in cases, GPs have found it hard to manage this area of wellbeing, particularly if they have had no specific training in that direction. The BMA, the NHS and other institutions offer mental health support and 24-hour crisis lines specifically for medical professionals. However, the problem cannot be resolved only with support, but prevention. General Practice must become a more manageable place in which to work, for the sake of both the workforce and the patients. 

What is expected from a GP in a ‘normal day’?

A day in the life of a GP is complex. Harmful rumours have been spread by certain parts of the press that doctors currently ‘don’t appear to be doing anything’. Unfortunately, some patients have been led to believe this, after the frustration of the difficulties of getting through to a surgery and speaking to a range of doctors, not knowing all the work going on behind the scenes. 

Even without the huge effect that COVID has had on the nation, GPs have been constantly under pressure with seemingly endless tasks such as training staff, sitting down with them to go through their case load every day, untold paperwork reporting (not just on patient care, but also on the management of the practice) frequently required by the CCG. Test results need to be checked, patients contacted, prescriptions issued – the list is somewhat endless. Currently, with little or no time for relaxation, the mental health problem is compounded. 

GPs need breaks for their mental health and a fair system which prevents such widespread mental health issues in the first place.