‘Bean counter’ GPS admit failing to spot danger signs

Family doctors say they are increasingly too busy filling in forms to pay full attention to patients

GPS HAVE said they have become so preoccupied with targets and “beancounting” that they are failing to spot deadly conditions.

In the UK study of family doctors, one GP described missing signs of a heart attack in a female patient, because they were “half-listening” to the patient while filling in forms.

The study, led by researchers from Barts and the London School of Medicine and Dentistry, said six in 10 GPS were suffering from stress, fuelling rising numbers taking early retirement.

During interviews, many described growing resentment and concern about the introduction of performance indicators in GP contracts, which were introduced under the last Labour government.

Researchers said: “The targets distorted the focus of clinical care onto a small number of conditions, turning clinical practice into a ‘treadmill’.

“Several GPS gave examples of being so preoccupied with the ‘bean-counting’ of targets that they were in danger of missing the obvious and serious,” the study found.

One described filling in a form which links outcomes to GP payments, and “half listening to what the patient was saying” before realising the woman was in the throes of a heart attack.

Another said: “You just put in more effort into the target and you neglect the other things you could or should be doing.” They questioned whether decisions were being taken in the best interests of patients.

The study involved in-depth interviews with 12 family doctors, who started out as GP partners in the 1970s and 1980s. Those in the study said their work had become increasingly fast paced, with conflicting requirements, a high workload and high responsibility, with little choice over how tasks are organised and paced.

In 2015, ministers pledged to increase the number of GPS by 5,000 by 2020. But since then numbers have fallen by around 1,000.

Dr Jennifer Napier, the study author, said: “Each GP in the study felt that over time they had experienced a reduction in the control they had over their highly demanding work. This research has highlighted the importance of allowing GPS the ability to make their own decisions and providing them with additional resources. the hope is that this will lead to a reduction in job strain and improve the retention of GPS.”

It follows disclosures that the number of GPS and hospital consultants taking early retirement has almost tripled in the last decade.

The figures from the NHS Business Services Authority show 983 such cases in 2018-19, compared with 384 a decade before. The statistics also showed rising numbers of retirements linked to ill health, with 203 such cases, a rise from 54 in 2008/9.

An NHS spokesman said: “Investment in local GP and community health services will increase by £4.5 billion over the next five years, helping fund 20,000 more multi-skilled staff to support GPS as part of the NHS Long Term Plan and provide a wider range of services for patients… with extra therapists, pharmacists and physios based out of GP surgeries.”