Full-time GPS a thing of the past, says new chief doc­tor

In­tense work­loads blamed as study shows only one in 20 trainees in­tends to work full-time in a GP surgery

The Daily Telegraph - - Front page - By Laura Don­nelly Health ed­i­tor

GPS can no longer be ex­pected to do the job full-time, the new head of Bri­tain’s fam­ily doc­tors has said, as new re­search shows just one in 20 young medics in­tends to do so.

Pa­tients groups said the find­ings were “alarm­ing,” amid a na­tional short­age of GPS that is con­tribut­ing to longer wait­ing times.

The King’s Fund re­search found just one in 20 trainee GPS plans to be work­ing full-time as a fam­ily doc­tor within a decade of qual­i­fy­ing, with most in­tend­ing to do be­tween one-and-a-half and three days a week. Prof Martin Mar­shall, who has just taken up his post as chair­man of the Royal Col­lege of Gen­eral Prac­ti­tion­ers, said the full-time job of a GP was now “un­doable”.

In his first ma­jor in­ter­view since tak­ing up the post, Prof Mar­shall, a GP in east Lon­don, said it would be wrong to think that mil­len­nial medics were more work-shy than pre­vi­ous gen­er­a­tions.

He told The Daily Tele­graph: “I think what this sig­nals is that the job of a GP is now un­doable on a full-time ba­sis. The idea that we can see 50, 60, 70 pa­tients a day, five days a week, is crazy.”

Such work­loads meant risk for pa­tients as well as doc­tors, he said.

“It is dif­fi­cult to be as sharp on your 50th pa­tient of the day, or [check­ing] your 200th blood test,” he said.

“Each one in­volves a clin­i­cal de­ci­sion, it car­ries a risk, which is an in­nately stress­ful de­ci­sion to make; it car­ries a de­gree of anx­i­ety that you might make a mis­take or mis­di­ag­no­sis. De­ci­sions can be life or death.”

Both Labour and the Tories have promised thou­sands more GPS.

But Prof Mar­shall said there would be “sig­nif­i­cant” work­force im­pli­ca­tions if so few doc­tors chose full-time GP roles. He also urged the pub­lic to think twice about whether they re­ally needed to visit their GP, in a bid to re­duce pres­sure on ser­vices.

JUST one in 20 trainee GPS in­tends to do the job full-time, re­search shows.

The study’s au­thors said their find­ings re­flected the in­ten­sity of the work­load fac­ing GPS, and could mean short­ages of doc­tors worsen.

Pa­tients’ groups said medics were lucky to be able to af­ford to work part­time, with av­er­age full-time earn­ings of £113,000 a year for a GP part­ner.

The re­search, by the King’s Fund think tank, polled 840 trainee GPS – doc­tors who work in gen­eral prac­tice, but are not fully qual­i­fied – and asked them about their fu­ture in­ten­tions.

One in 20 planned to work full-time as a GP within a decade of qual­i­fy­ing, with most in­tend­ing to work be­tween one-and-a-half and three days a week.

For the past five years, fe­male GPS have out­num­bered male GPS, with women of­ten choos­ing the role be­cause it was seen as more “fam­ily friendly” than hos­pi­tal work. Now, 57 per cent of fam­ily doc­tors are fe­male.

The re­search showed that men were al­most as likely to want to do the job on a part-time ba­sis, with 74.9 per cent of fe­male trainees, and 73.4 per cent of male trainees, hop­ing to work a max­i­mum of six half-day ses­sions, or three days a week. How­ever, women were more likely than men to want to limit their du­ties to three half-day ses­sions.

Around half of the trainees polled hoped to have a “port­fo­lio” ca­reer, in­clud­ing other work, such as re­search.

The prime rea­son for not want­ing to work as a GP full-time was the “in­ten­sity of the work­ing day”, closely fol­lowed by fam­ily com­mit­ments. Long work­ing hours, high vol­umes of ad­min­is­tra­tive work and work-re­lated stress were other fac­tors cited.

Al­ready, less than one third of GPS work full-time, of­fi­cial fig­ures show.

Last month, Bri­tish Med­i­cal As­so­ci­a­tion mem­bers voted to axe home vis­its, in or­der to lessen GPS’ work­loads.

Joyce Robins, from Pa­tient Con­cern, said: “The sit­u­a­tion is alarm­ing. A lot of peo­ple would like the lux­ury to work part-time, but mean­while mil­lions of pa­tients are suf­fer­ing, with longer and longer waits to see a doc­tor.”

Beccy Baird, a se­nior fel­low at the King’s Fund and the study’s lead au­thor, said re­cent po­lit­i­cal pledges to ex­pand the num­ber of GPS ap­peared to have used num­bers “plucked from the air”, say­ing it was un­clear whether they would be enough to tackle the cri­sis.

The Tories have pledged to in­crease to­tal GP num­bers by 6,000, while Labour has said it will in­crease the num­ber of trainees an­nu­ally by 1,500, mean­ing 5,000 are trained a year.

Ms Baird said: “GP work­load is in­cred­i­bly in­tense at the mo­ment. It is too in­tense to work full-time. See­ing a pa­tient ev­ery 10 min­utes, or hav­ing phone calls with them, for eight hours a day plus four hours’ fol­low up – that’s not sus­tain­able.”

Prof Martin Mar­shall, the new head of the Royal Col­lege of GPS, said the find­ings showed that do­ing the role full-time was now ”un­doable”.

“The idea that we can see 50, 60, 70 pa­tients a day, five days a week, is crazy,” he told The Daily Tele­graph.

Fig­ures from NHS Dig­i­tal show that over the past year, the num­ber of pa­tients wait­ing at least a month to see a GP has risen by al­most a fifth.

In to­tal, 5.8 mil­lion pa­tients waited over a fort­night to see their GP af­ter book­ing an ap­point­ment last month – a 13 per cent in­crease com­pared with the same point last year.

Prof Martin Mar­shall, head of the Royal Col­lege of Gen­eral Prac­ti­tion­ers, said full-time work for GPS was ‘un­doable’

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