The relationship between a GP and their patient is based on trust, often built over time. GPs are consistently rated as some of the most trusted professionals in society.
Yet that bond is under threat.
Patient satisfaction rates in their GP practice actually rose during the pandemic to the highest in three years. According to the annual GP patient survey, 95% of patients say they have confidence and trust in the healthcare professional they saw; and 94% say their needs were met when they last visited their local practice.
Without being complacent, I’m not surprised because GPs and our teams have been working our socks off throughout the pandemic, delivering essential care and services when many other parts of the NHS shut down.
We’ve ensured patients have been able to access care safely, in person where clinically necessary, in line with Government advice.
We’ve ensured patients are protected from flu, which can be a serious illness for those at greatest risk, by rolling out the largest vaccine programme yet. And we’ve played a leading role in the Covid vaccination effort, protecting people from the virus that has blighted our lives for the last 18 months, with three quarters of all vaccines delivered in primary care.
Yet over the last couple of months, GPs and our teams have been subjected to a torrent of unfair and frequently offensive criticism from certain parts of the UK’s media and some politicians. It’s been the worst I can remember in 30 years as a GP.
The root of it all is based on a concerning narrative that remote consultations aren’t as good as face to face appointments. It’s absolutely true that face-to-face appointments are often necessary – and they are happening. Almost 24 million patient appointments were made in August, 46% on the same day they were requested, and almost six in 10 are currently face to face. That’s nearly 14 million in a month. To claim face to face consulting isn’t happening is wrong.
Many patients do prefer seeing their GP in person, and many GPs prefer seeing their patients in person. But good care can also be delivered remotely and some patients prefer it. GP appointments over the phone or online can be convenient and fit around other commitments, and they can make some people feel more comfortable to seek medical help when they need it or discuss things about their health they might be embarrassed to otherwise.
The latest onslaught has been about GPs working part time. But if you actually look at the hours worked by a ‘part-time’ GP working three days a week, they are longer on average than what would be considered full time by most people – around 40 hours. A quarter of GPs are working 50 hours a week or more. To put that into context, a pilot is restricted to flying 32 hours over seven days – because doing more would be considered unsafe.
GPs are making difficult, important decisions every day, in every consultation. Sometimes these are life or death decisions. Forcing GPs to work longer hours is dangerous. Patients shouldn’t have to see tired GPs.
GPs, and other members of our teams, join the profession to care for patients. It is the relationships that we build with our patients that make the job worthwhile. I often say that a good relationship with a patient is to a GP what a scalpel is to a surgeon. It’s the most important tool we have.
General practice teams are working so hard right now, trying to do their best for patients in as safe a way as possible. To consistently be told you’re not doing enough is demoralising. It’s having a dangerous impact our relationship with our patients, with numerous reports of practice staff being on the receiving end of abuse from frustrated patients. And it’s having an impact on the mental health and wellbeing of GPs and our teams.
A survey by the College earlier this year found 60% of GPs reporting their mental health has deteriorated over the last year. The same survey found that 34% of GPs said they were thinking of leaving the profession in the next five years - a quarter of those due to stress and burnout. That could mean 14,000 highly trained, experienced GPs leaving frontline patient care - at a time when we need thousands more to deliver the care we want to: the care our patients need and deserve.
Our big fear is that this current unfair criticism, on top of existing pressures, will be the final straw for many GPs and other practice team members, causing them to leave the profession before their time. It also stops bright and brilliant medical students from training to become GPs, and the consequences will be serious.
We share the frustrations of our patients, who are finding it more challenging to access our services. The reality is, there are simply not enough GPs, and those we do have are working under intense pressures. Workload is escalating, but GP numbers have fallen since the Government promise of 6,000 more family doctors was made.
Patients need these GPs. We also need the 26,000 members of the wider practice team that were promised, and for unnecessary bureaucracy to be addressed, so we can spend more time with our patients. But the Government also needs to recognise that NHS pressures are not confined to hospitals and that general practice is under unprecedented strain.
GPs, our teams, and colleagues right across the health service have worked to their limits over the last 18 months. Divisive and distorted accusations about ‘lazy’ and ‘uncaring’ GPs demoralise the very people who are going above and beyond every day to keep the NHS running safely for patients.
Everyone deserves a family doctor. We need our patients, the public, politicians and the media to support our GPs – before it’s too late.
