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| 'Now I'm a locum my marriage is surviving': GPs on job pressure | 'Now I'm a locum my marriage is surviving': GPs on job pressure |
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| In the light of a survey showing a third of GPs in England think they may no longer be working in five years’ time, we asked you to share your experiences | |
| Lottie Jackson and | |
| Guardian readers | |
| Tue 8 Aug 2017 07.00 BST | |
| Last modified on Wed 20 Sep 2017 23.04 BST | |
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| The pledge to increase GP numbers by 5,000 within three years is “unachievable” according to the British Medical Association’s committee chair. The majority of GPs are struggling to cope with the increasing demand on primary care, and as a consequence unprecedented numbers are leaving to work abroad or retiring early. | The pledge to increase GP numbers by 5,000 within three years is “unachievable” according to the British Medical Association’s committee chair. The majority of GPs are struggling to cope with the increasing demand on primary care, and as a consequence unprecedented numbers are leaving to work abroad or retiring early. |
| The annual report of the Royal College of GPs said people in the profession “could reach breaking point” as recruitment numbers fell since September 2016. We asked GPs to tell us about the pressures they face. | The annual report of the Royal College of GPs said people in the profession “could reach breaking point” as recruitment numbers fell since September 2016. We asked GPs to tell us about the pressures they face. |
| Liz Dawson, 38, Oxfordshire: ‘Our patients had come to expect a certain standard of care that we were no longer able to provide’ | Liz Dawson, 38, Oxfordshire: ‘Our patients had come to expect a certain standard of care that we were no longer able to provide’ |
| In 2014 my practice was ranked top in my county for patient satisfaction by the NHS friends and family test; last month it was ranked bottom. At the end of June this year my two remaining partners and I left the surgery: we had a total of nearly 50 years’ experience at the practice between us. We went from a partnership of seven to a partnership of three treating 16,500 patients and unfortunately we just couldn’t make it work. Once we were unable to recruit permanent doctors we had to use lots of locum GPs, which is much more expensive. | In 2014 my practice was ranked top in my county for patient satisfaction by the NHS friends and family test; last month it was ranked bottom. At the end of June this year my two remaining partners and I left the surgery: we had a total of nearly 50 years’ experience at the practice between us. We went from a partnership of seven to a partnership of three treating 16,500 patients and unfortunately we just couldn’t make it work. Once we were unable to recruit permanent doctors we had to use lots of locum GPs, which is much more expensive. |
| The gap between money coming in and money going out became smaller over time and it became impossible to make ends meet as our patients had come to expect a certain standard of care that we were no longer able to provide. The current system rewards mediocrity not excellence and the money the government are spending on healthcare makes it impossible to provide excellent care. There has to be a better way. The last few years have taken a huge personal toll. No one goes to work to do a bad job: it is soul destroying that the government is making it so hard for me to do a job I love. | The gap between money coming in and money going out became smaller over time and it became impossible to make ends meet as our patients had come to expect a certain standard of care that we were no longer able to provide. The current system rewards mediocrity not excellence and the money the government are spending on healthcare makes it impossible to provide excellent care. There has to be a better way. The last few years have taken a huge personal toll. No one goes to work to do a bad job: it is soul destroying that the government is making it so hard for me to do a job I love. |
| Makeen, 40, West Midlands: ‘We live in fear that vexatious complaints will end our careers’ | Makeen, 40, West Midlands: ‘We live in fear that vexatious complaints will end our careers’ |
| I am within my first five years post-qualification and I am looking for a way out – and quickly. The demand is excessive as patients think everything is an emergency and demand to be seen the same day for things that previously they would have self-cared for. This means on a daily basis I can have 80-100 patient contacts or more. As a human I feel I am not able to process such information accurately and with the level of care I would like to deliver. | I am within my first five years post-qualification and I am looking for a way out – and quickly. The demand is excessive as patients think everything is an emergency and demand to be seen the same day for things that previously they would have self-cared for. This means on a daily basis I can have 80-100 patient contacts or more. As a human I feel I am not able to process such information accurately and with the level of care I would like to deliver. |
| The media vilifies GPs and paints us in one breath as people who are “best placed” to deal with a number of things. This includes recently telling us to ask about fire safety awareness in tower block residents, which is completely inappropriate as we don’t have the skills. We live in fear that vexatious complaints will end our careers. I don’t want to go into work or see some patients because of this. I am ready to give it up. | The media vilifies GPs and paints us in one breath as people who are “best placed” to deal with a number of things. This includes recently telling us to ask about fire safety awareness in tower block residents, which is completely inappropriate as we don’t have the skills. We live in fear that vexatious complaints will end our careers. I don’t want to go into work or see some patients because of this. I am ready to give it up. |
| Mike, 41, Sussex: ‘Those who do become GPs are more likely to do locum work’ | Mike, 41, Sussex: ‘Those who do become GPs are more likely to do locum work’ |
| I have been a GP partner for the last eight years in a small practice. We have multiple generations of the same family registered with us and it is a real privilege to make a difference in the lives of these families. We are aware of the social situation of many of our patients, which enables us to provide real family based care which is a great benefit when we see individuals of that family. I love my job, but due to repeated GP bashing by the media young newly qualified doctors are choosing not to enter general practice. Those who do become GPs are more likely to do locum work as they don’t want the additional paperwork, financial risk and the management role which becoming a partner requires. | I have been a GP partner for the last eight years in a small practice. We have multiple generations of the same family registered with us and it is a real privilege to make a difference in the lives of these families. We are aware of the social situation of many of our patients, which enables us to provide real family based care which is a great benefit when we see individuals of that family. I love my job, but due to repeated GP bashing by the media young newly qualified doctors are choosing not to enter general practice. Those who do become GPs are more likely to do locum work as they don’t want the additional paperwork, financial risk and the management role which becoming a partner requires. |
| Tamar Morton Jones, 38, Leicester: ‘I would like my job if it were manageable’ | Tamar Morton Jones, 38, Leicester: ‘I would like my job if it were manageable’ |
| I came into general practice hoping to have some work-life balance but I have always worked long, hard hours. I am making decisions that carry a great deal of responsibility, with barely time to take a breath. After a couple of years I became ill and I remain unwell and disabled. This was very likely related to the high levels of stress. I am still practicing but over the last five years I have tried many adaptions but the problem is always the same: there is always so much work. And you can’t just leave it, because people are depending on you. I would like my job if it were manageable. GPs have reported the coming crisis for many years and have been ignored. This needs urgent action and the government’s response is laughable. | I came into general practice hoping to have some work-life balance but I have always worked long, hard hours. I am making decisions that carry a great deal of responsibility, with barely time to take a breath. After a couple of years I became ill and I remain unwell and disabled. This was very likely related to the high levels of stress. I am still practicing but over the last five years I have tried many adaptions but the problem is always the same: there is always so much work. And you can’t just leave it, because people are depending on you. I would like my job if it were manageable. GPs have reported the coming crisis for many years and have been ignored. This needs urgent action and the government’s response is laughable. |
| Barbara Compitus, 42, Bristol: ‘I was burning out and something had to give’ | Barbara Compitus, 42, Bristol: ‘I was burning out and something had to give’ |
| I was a partner at a GP surgery until 12 months ago. I felt unable to continue in this position due to decreasing funding and a massive increase in workload. It is a combination of patient demand, paperwork and supporting staff across the system that is failing them. I was burning out and something had to give. I am so sad that my profession appears to have been deliberately targeted for destruction by a government driven by an ideology that has no regard for the human cost. | I was a partner at a GP surgery until 12 months ago. I felt unable to continue in this position due to decreasing funding and a massive increase in workload. It is a combination of patient demand, paperwork and supporting staff across the system that is failing them. I was burning out and something had to give. I am so sad that my profession appears to have been deliberately targeted for destruction by a government driven by an ideology that has no regard for the human cost. |
| I work as a locum as this is the only way for me to control my workload and predict my income. I have been able to just focus on the person in front of me – their ideas, concerns and expectations – it’s wonderful. I really worry what the future holds, as without a robust GP service the NHS has no foundation. | I work as a locum as this is the only way for me to control my workload and predict my income. I have been able to just focus on the person in front of me – their ideas, concerns and expectations – it’s wonderful. I really worry what the future holds, as without a robust GP service the NHS has no foundation. |
| Evidence suggests we lose the ability to make good decisions after 30 patient contacts | Evidence suggests we lose the ability to make good decisions after 30 patient contacts |
| Amanda, 43, Nottingham: ‘Now that I am a locum my marriage is surviving and my kids get to see me’ | Amanda, 43, Nottingham: ‘Now that I am a locum my marriage is surviving and my kids get to see me’ |
| I was a partner for 14 years and had to quit, for my health and for my family. My marriage nearly ended, in large part due to my job. I have also been very depressed as a result of all the stress. I hardly saw my kids on my work days. I would see more than 50 patients a day even though evidence suggests that we lose the ability to make good decisions after 30 patient contacts. | I was a partner for 14 years and had to quit, for my health and for my family. My marriage nearly ended, in large part due to my job. I have also been very depressed as a result of all the stress. I hardly saw my kids on my work days. I would see more than 50 patients a day even though evidence suggests that we lose the ability to make good decisions after 30 patient contacts. |
| I am now a locum, and more GPs are doing this in order to keep sane. I can now choose to work 5-8 hours a day and be paid better than when I was a partner. Of course, there is no paid sick leave or job security and it can be lonely constantly changing teams. However, my marriage is surviving and my kids get to see me. I am finally coming through it and am much happier. If I hadn’t done this I’d have quit. | I am now a locum, and more GPs are doing this in order to keep sane. I can now choose to work 5-8 hours a day and be paid better than when I was a partner. Of course, there is no paid sick leave or job security and it can be lonely constantly changing teams. However, my marriage is surviving and my kids get to see me. I am finally coming through it and am much happier. If I hadn’t done this I’d have quit. |
| Daniel Prem, 43, Newcastle upon Tyne: ‘I want money for staff, premises and patients, not for my own income’ | Daniel Prem, 43, Newcastle upon Tyne: ‘I want money for staff, premises and patients, not for my own income’ |
| I am a GP working in the most deprived ward in Newcastle and facing the typical pressures of urban practice. There has been a significant change in work since I started, with the working day becoming longer and more intense due to greater emphasis being placed on primary care. On top of this we are seeing a gradual erosion of funding, which means we aren’t able to invest in services that would benefit our patients. We are deliberately reducing our own incomes to increase staff numbers to cope with these pressures. This shouldn’t be the dilemma that practices face. Too often we hear that we’re paid enough. I want money for staff, premises and patients – not for my own income. | I am a GP working in the most deprived ward in Newcastle and facing the typical pressures of urban practice. There has been a significant change in work since I started, with the working day becoming longer and more intense due to greater emphasis being placed on primary care. On top of this we are seeing a gradual erosion of funding, which means we aren’t able to invest in services that would benefit our patients. We are deliberately reducing our own incomes to increase staff numbers to cope with these pressures. This shouldn’t be the dilemma that practices face. Too often we hear that we’re paid enough. I want money for staff, premises and patients – not for my own income. |
| I work in an amazing practice with fantastic colleagues and do a worthwhile job. But how can it be right that the only way to cope and continue in the profession is to do less of it? We have lots of innovative ideas and are at the forefront nationally in the use of some consultation methods. There is no funding for these. We lack the administrative and managerial support that colleagues in hospitals receive to perform their roles. We could do so much more but we need investment. | I work in an amazing practice with fantastic colleagues and do a worthwhile job. But how can it be right that the only way to cope and continue in the profession is to do less of it? We have lots of innovative ideas and are at the forefront nationally in the use of some consultation methods. There is no funding for these. We lack the administrative and managerial support that colleagues in hospitals receive to perform their roles. We could do so much more but we need investment. |
| Some names have been changed to protect identities. | Some names have been changed to protect identities. |
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