Legal blog: A tired and overworked GP workforce benefits no one

The working culture of GPs continues to dumbfound many within the primary care sector. Tom Gough, senior solicitor in the medical negligence team at Bolt Burdon Kemp outlines how the Royal College of General Practitioners (RCGP) new safety campaign seeks to protect GPs from the dangers of being overworked – and what to look out for when it comes to common medical negligence claims

A new campaign by the RCGP hopes to highlight the heavy workloads facing GPs. “A rested GP is a safer GP”, will encourage GPs to take regular breaks and not to overwork – due to concerns that patient safety might be jeopardised by exhausted GPs.

The workload of GPs has never been greater. GPs across the UK see approximately one million patients a day, with some seeing in excess of 40 patients daily. There are approximately 1,080 patients to every registered GP in the UK. Pressure on GPs to offer convenient appointment times means they often work late into the evening and on weekends. They must also remain focused as consultations are often only 10 minutes long.

Despite the amount of patients being seen, numbers of new GPs have grown at less than five per cent over the last five years. The natural result of this is a tired, overstretched GP workforce, with more pressure being placed on GP involvement in NHS management. In addition, the government plans to increase workloads further, with promises of a seven-day service by 2020, without a clear plan for recruitment.

Dr Maureen Baker, Chair of the RCGP, raised concerns last year regarding the extreme workload faced by GPs and its potential effect on patient safety.

She said: “GPs will always work in the best interests of their patients…but, ironically, this can actually have an adverse effect on patient safety.”

The risks to patient safety caused by overworked GPs are clear. The focus on 10 minute consultations and high turnover of patients results in a process driven culture – identify the patient’s key issues, action them, and move on to the next patient.

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However, the care of some patients is not that simple. What may appear to be an easily identifiable presentation, could be a more threatening illness. One set of symptoms may indicate a myriad of problems. When a patient has to wait several weeks for an appointment – and only see a doctor for 10 minutes each time – serious conditions may be missed.

A tired GP will struggle to be a good GP. Every consultation should be approached with care. It is clearly difficult for tired GPs to approach every patient with the same level of attention and consideration – when they are seeing 40 or so patients over a long day and evening.

A common basis for medical negligence claims against GPs is the failure to refer patients with concerning symptoms early enough. When this happens, patients often complain of feeling like they weren’t being listened too, or that they were being rushed out of the room. This is likely to be because of limited appointment slots and overworked, tired GPs.

One way to protect patients from mistakes is to protect GPs from being overworked. The only answer is to recruit more GPs. This will ensure that their workloads are managed more effectively, and that they can take regular breaks to avoid fatigue. To help protect GPs and patients, the NHS has to provide a clear plan for higher levels of GP recruitment.