Dr Hilary outlines 'worry' for rise in coronavirus infections
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On average, they thought a safe daily limit would be 28. Just over half said consultations were taking longer now than before the pandemic, and some were worried about missing vital body language signs when not seeing patients face-to-face. More than 1,400 family doctors responded to the survey on March 1 by GP publication Pulse. When asked if they felt that their workload was safe on that day, 49 percent said no. Four in 10 said yes and the rest didn’t know.
GP leaders had warned that an unsustainable increase in workload was pushing some staff to breaking point even before the pandemic. The latest findings were similar to Pulse’s first survey in 2019, in which GPs revealed they were working 11-hour days including eight hours of clinical appointments.
Professor Martin Marshall, chairman of the Royal College of GPs, said: “The pandemic has only exacerbated these pressures.
“GPs and our teams continue to work long days – well above their ‘normal’ hours – as they strive to deliver the care patients need, as well as all their other responsibilities.
“This isn’t sustainable and, as these survey results show, working under these intense pressures is impacting on GPs’ health and wellbeing, and potentially patient safety.”
Prof Marshall warned the intense pressure is likely to get worse.
He said: “Not only will we continue to deliver the routine care our patients rely on us for, but we are supporting patients whose mental and physical health has been impacted by Covid-19 – including long Covid – and lockdown restrictions. And we’re caring for the backlog of patients who may have been reluctant to access health services at the height of the pandemic, or whose care was postponed as a result of the pandemic response.”
NHS England board papers recently revealed that when Covid vaccinations are taken into account, practices delivered one million more appointments per week in January than before the pandemic – a 15 percent increase.
Some 35 percent of GPs said their workload was “significantly” higher now, and a further 35 percent said it had increased “slightly” compared to pre-Covid times.
In January 2020, 80 percent of consultations were carried out face-to-face and 14 percent by phone.
At the height of the first wave in April, the proportion of face-to-face fell to 47 percent and by phone increased to 48 percent.
A small number of consultations were also carried out by video or via home visits.
Some 55 percent of GPs said the length of consultations was now “significantly” (24 percent) or “slightly” (31 percent) longer than before because of the need to sanitise and change PPE.
Dr Paul Evans, chairman of the Gateshead and South Tyneside Local Medical Committee, who took part in the poll, said: “Morale is suffering and many are on the brink of exhaustion. This tempo of work can’t be maintained.”
Kent LMC medical director Dr Andy Parkin said: “A lot of practices are finding it hard to manage the vaccination workload, the increasing day-to-day work and patient expectations of being able to contact their GP whenever they want.”
Dr Richard Vautrey, chairman of the British Medical Association’s GP Committee, said there was a misconception that remote working was easier for GPs. He said: “The opposite is often true.” He is also worried about next winter “when not only will we have the annual flu programme alongside any further vaccination boosters required, we will also need to address the huge backlog of care while there is the potential for further spikes in coronavirus”.
Dr Vautrey called on the Government to ensure general practice has the necessary staff, funding and resources to provide safe and timely care for patients.
An NHS spokesman said: “GPs, like all NHS staff, have faced challenges with Covid-19.We have provided a number of financial and practical measures to support practices and staff which include coaching and mentoring, additional financial support for clinical directors and £270million to expand general practice capacity during the pandemic.”
Comment by Rosemary Leonard
When I did the Census recently I realised I had worked 60 hours for the NHS the previous week – and that’s standard.
This time last year, when the first lockdown started, it all went eerily quiet and nobody wanted to come into the surgery. But we’re paying for it now.
We are seeing all the problems that people didn’t want to come forward with last year coming out of the woodwork.
In a sense that’s a good thing, but if your practice is also involved in giving vaccines, as mine is, it means clinical staff are being diverted away. We’ve got two doctors off giving vaccines, leaving us short in the surgery while dealing with an increased workload.
People contact us by phone and email. It can be more efficient for the patients but it’s highly pressurised at our end. As I write, it’s only lunchtime and we’ve had more than 50 emails come in and done 60 calls.
Currently there is only me and a trainee here. I’ll be working for 10-12 hours solid.
You have to try to switch off in the evening but I try to look through emails and make sure there isn’t anyone who has an urgent problem.
I’ll also be working for 12 hours on Good Friday and Easter Saturday giving vaccines.
We really wanted a break over Easter but then we were told Pfizer vaccines would be arriving. We have no control over deliveries – and they have to be used in three days.
The vaccine pressure is going to continue for at least six months. Then it will be flu vaccines in the autumn and maybe top-up Covid jabs.
The other problem is that hospitals are still only taking urgent referrals, putting more pressure on primary care.
What we need is more financial support for locums to help us out. We need more manpower.
• Rosemary Leonard is a GP and Express columnist
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