Doctors need flexible working or they will leave, says GP

Dr Sandesh Gulhane discusses why it needs to be made possible for staff to share their feelings with their bosses in a safe environment with no judgment

CREDIT: This is an edited version of an article that originally appeared on iNews

The NHS has always been a national source of pride, and the weekly clapping showed people’s admiration for the 72-year-old institution. But look below the surface and you will see the crisis that is engulfing our health service.

The bedrock of the NHS is the staff, from the porters who ferry equipment and patients around, to the nurses and doctors who are on the frontline treating patients and saving lives. Many of these staff members were suffering from burn-out and stress before the COVID-19 crisis.

I want to take you back to 2019, a year that seems so long ago now, before anybody knew where Wuhan was and what COVID-19 was. Morale was at an all-time low, with record numbers of doctors who had only been qualified for two years needing to take a career break because of stress and burnout. Many left the UK, taking the £220,000 we invested in their training with them, never to return. I cannot blame them; the allure of sandy beaches, hot weather and significantly improved working conditions is a heady mix that I only resisted because of my growing family.

The story was no different for nurses, with huge vacancies leading nurses to work unpaid overtime to cope. This all culminated in staff feeling stressed, which led to absenteeism and turnover.

COVID-19 struck in December and widened the cracks that were already present. We all banded together as much as possible to repel the first wave. In hospitals we stopped our regular, routine work, moved departments, covered specialities we were unfamiliar with and worked long hours – whilst, as a GP, I had to radically change the way that I worked by learning about remote consultations. I had a huge volume of calls from patients about COVID-19, and about the fact that hospital appointments were cancelled, leading to ongoing pain and suffering. I had to increase the hours I worked to keep up with the demand; this has led us to be exhausted and feeling deflated right now.

Compassionate leadership needed

A report from the Kings fund has shown that increasing numbers of nurses are quitting their jobs within three years of joining due the exhausting 12-hour shifts, with some reporting having poor access to food or drinks when at work. Looking at the details of this report, and beyond, it is clear that we need the compassionate leadership that they are calling for, and to look for innovative solutions to the crisis.

Introducing weekly Balint sessions – which are small, confidential group talking sessions allowing staff to speak about their feelings around tragic cases and their involvement – will help to reduce stress. Creating flexible working for all staff in the NHS to allow family time and a work-life balance will create more harmony while at work. This approach has served GPs well, allowing parents to continue working, whilst fulfilling their commitment to their children.

Why is this important? Because the second wave is upon us, and the winter cold and ‘flu season has arrived with it. The winter has always been a busy time for doctors, with more people suffering and seeking help from GPs and being admitted to hospitals.

As a GP in Glasgow I have read claims about how I am not doing enough to help, but that is far from reality. Last Monday we had 170 patients contact the surgery wanting consultations, and there were only four doctors available. I dealt with patients having mental health breakdowns, possible cancers and chronic pain, whilst also trying to manage patients who have had their hospital appointments cancelled. I also saw patients face-to-face when I felt it would change my management of them. The winter pressure is going to be made far worse if we have a large COVID outbreak and we will have a situation where the NHS is overwhelmed.

Practices inundated

It is possible that this winter could see GP practices inundated, leading to impossible workloads and GP surgeries having to create maximum capacity for appointments. Intensive care beds could be full, with no room for those who are gravely sick, and hospital corridors lined with patients. We saw this in Italy six months ago, and it could be our reality.

Couple this extra pressure with stressed, burned out and overworked staff and we will see staff going off sick, or leaving, adding fuel to the fire. The alternative is to improve the morale of our staff and to prevent the spread of the coronavirus by following some basic rules: wash your hands, socially distance and wear your mask. The other rules seem confusing, and not aligned, but we can do our best to follow these too.

To help staff at our GP surgery we have a ‘wobble room’, where we can go if we are having a bad day – and there are even free chocolates for us if we want. We have some time at the end of the day to decompress, and speak to each other, to allow us to get things off our chest and ask questions about patients we have managed. We need to make it possible for staff to bring up their feelings with their bosses in a safe environment, with no judgment, but with tangible help available to them.

These are things that every employer and NHS department should instigate, but the biggest thing that will help us in general practice and across the NHS is kindness from within and without. We need your support and understanding that things are not normal, and we cannot do the things we have traditionally done as the demand is simply too high.

Support us to support you, and help us deliver the care we desperately want to.