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Under Pressure: UK Doctors Claim Stress Levels Too High to Offer Quality Care

Posted on Jun 26, 2013 by Sergio Ulloa ()  | Tags: Ae, budget, doctors, elderly, GPs, Health, medical students, pressure, RCGP, stress, survey, UK

A survey published last week in the UK has drawn attention to the stress and pressure that General Practitioners across the country face just to perform their weekly tasks: 49% of GPs state that the level of care they provide to patients is compromised as a result.

The survey, which was conducted by the Royal College of General Practitioners (RCGP), paints a very dark picture of the current situation for UK doctors and British general practices which are claimed to be increasingly stressful work environments.

It is often thought that GPs have a more relaxed work schedule, and an easier working week compared with hospital doctors who work shifts, deal with emergencies and spend much longer on their feet moving between hospital wards. Despite these assumptions, the recently published RCGP report claims that 20% of the 258 GPs interviewed had sought help for work-related stress. The main reasons for this were the high volume of patients they have to see each day and because of long work hours; 46 per cent of GPs claimed to spend over 11 hours of each day at their GP surgery.

Doctors claim that the pressures on their daily workload comes as a direct result of budget restraints which mean that GPs are currently allocated just 9% of the annual NHS budget. This financial constraint makes it difficult for practices to take on new hires- and the problem is aggravated by an increase in the number of senior GPs stopping work each year (this number reached a ten year high in 2010 when 7.8 per cent of GPs either resigned or retired). Both factors leaves those General Practitioners still employed by the NHS with an unmanageable number of daily consultations to attend to (which regularly ranges from 40 to 60 patients), as well as completing the administration work which accompanies the consultations.

The news comes as a surprise to some because as recently as May this year, UK GPs faced criticism from the Secretary of state for health, Jeremy Hunt who indicated that the reason for increasingly long waiting lists at Accident & Emergency departments was connected to GPs who gave up 24 hour patient care in exchange for pay cuts. Until 2004 GP work contracts required doctors to provide an out of hours service for their patients, but changes to the GP contract under the labour government meant that they could opt out of in exchange for a 6,000GBP reduction in annual salary. Statistics indicate that the end of out of hours GP services resulted in an additional 40% demand on A&E departments across the UK.

Despite this, and calls for GPs to return to the original out of hours policy, the recent RCGP survey indicates that the GPs are already working more than enough hours: nearly half of the general practitioners surveyed claimed that they already worked until after 7pm on a daily basis. In response to Jeremy Hunt's calls for doctors to take on more responsibility for the health of the community, 93 per cent of GPs felt that their work had become increasingly stressful over the last five years.

In addition to budget cuts, changes in population demographics mean that the UK, like many other nations, has an increasingly aging population. This also adds pressure to the GP profession. According to 2011 census statistics, the number of people over 65 passed 10 million for the first - and by 2033 this number is anticipated to double. Clearly, these numbers say great things about an increasing healthy population in the UK, but they will undoubtedly bring further strain to GPs. There are already predictions that the number of doctors appointments needed will double from approximately 90 million appointments now to an estimated 180 million appointments by 2035.

Even more worrying for general practitioners is that the number of people aged 85 and over are currently the fastest growing age group in UK. It is predicted that these numbers will continue to grow and that over the next 30 years, the number of 85-year-olds will increase three fold. There is no doubt that this age group already make up a massive section of British society and take up a significant amount of GP time with regular medical checks and attention due to frailty and lower levels of immunity. This is especially true in winter when cold and flu epidemics take their toll on the elderly population and result in a huge increase in demand for GP appointments.

The RCGP report has brought UK health care back to the headlines, and forced the Department of Health to acknowledge the current situation for GP. The DoH admitted that "GP surgeries had become extremely busy", and in a statement issued by an NHS England expressed a desire "to explore with the profession how we can best enable GP practices to continue to provide a quality service." The Department of Health has accepted that part of the problem can be tackled by increasing the number of GPs.

The chairwoman of the RCGP, Clare Gerada, has suggested that the first port of call to tackle the overwhelming pressure on GPs, will be to increase the general practice budget. She insists that an increase in the budget of 1% would allow an additional 10,000 new GPs to be employed by the NHS. Another solution is to work closely with medical schools and medical students to encourage them to become GPs. The DoH has reached out to Health Education England to try to get 50% of medical students to become GPs in the future. In addition to this, another preventative measure will involve health services for elderly people in order to reduce the pressure on general practice surgeries. Professor David Taylor, a researcher at UCL's School of Pharmacy who has been investigating the increasing significance of an aging population on the UK economy. He has announced that there will need to be "sufficient policies to keep the elderly healthy including improved pharmacy services and community nursing support".

It is expected that combination of all these initiatives will be needed in order to improve the current quality of service, retain current GPs and prevent future medical graduates from emigrating to countries with less stressful work conditions for GPs.

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