A Scots GP has told how patients’ lives are being put at risk because doctors are so overworked their mental health is being affected.
Dr Amy Small, a locum GP in Midlothian, is part of the Rebuild GP Campaign which says that a shortage of GPs and a massive increase in demand for services has led to “burn-out” among doctors – patients at risk.
A poll carried out last month by the campaign – co-run by BMA Scotland and the General Practice Defense Fund – found 86 per cent of Scotland’s GPs who responded said they had felt anxiety, stress, or depression in last year.
Now calls have been made for the Scottish Government to recruit hundreds of new GPs to ease the crisis in Scotland’s local health centres.
Revealing the shock results of the mental health survey among GPs, Dr Small said: “We have hit a point now where things are so tight in general practice that we have this perfect storm where issues of retention and recruitment are now actually causing issues of patient safety.
“GPs have been calling for some time for more recruitment. The Scottish Government had promised 800 GPs by 2027 but we have yet to see evidence of that.
“GPs are retiring early because of pension changes that are harshly penalising them and GPs are burning out because workload is just overwhelming.
“And that combined with the media campaign targeting general practice has really dropped morale.”
Dr Small continued: “It is getting completely overwhelming at the moment.
“I have seen friends who I thought were unshakeable people. People I thought would go on forever as full-time partners now resigning completely from their partnerships.
“People who I never thought in a million years would be affected and are now having to seek mental health support and are unable to do clinical work.
“The numbers with depression and anxiety are increasing. People generally are struggling to find a workload balance.
“And I think as soon as you throw something else into the mix, like personal illness or having to manage a young family, that one thing tips it.
“When you are giving every last bit of you to your patients, there isn’t room for anything else.
“As soon as that last bit comes, boom that’s it, you are really struggling.
“You as a patient don’t want to go and see a sick doctor who is not coping.
“My concern is because we are having to make too many decisions we are getting decision fatigue and that, in turn, is going to affect patient care and patient safety.
“If you have got a doctor who is tired, working more hours than they should be who has already spoken to 50 other patients that day, you are worried about what decisions are going to be made.
“We know that safe patient contacts should be about 25 a day but doctors are seeing far more.
“There’s also the issue because patients aren’t managing to get through they are dealing with things themselves.
“I have had patients saying to me ‘we were told to not contact the NHS and stay at home so I didn’t want to bother anyone’ and then if they phone and are told they are number 75 in the queue or there are no appointments left that day.
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“Then they are going to sit at home with things that if we had been better staffed, better resourced, we would have been able to manage.”
And she said the increase in mental health problems among patients because of delays in getting them operations has soared.
“Patients might have a sore hip but they are waiting two years to get operated on. That sore hip has meant they can’t go out, they are socially isolated, they are depressed, they have maybe gained weight through that and are maybe battling other diseases like diabetes.
“How can you deal with that full whammy of multiple co-morbidities in 10 minutes? If that is your last appointment of the day and you have just dealt with 35 people prior to that, the person is not going to get the best care they deserve.
“We might not pick up the subtleties of what else patients are trying to bring us.
“We can do our job efficiency, appropriately or we can do it really well.
“We want to do it really well but when there is absolutely no slack in the system it’s absolutely impossible to meet the full needs of patients.
“It is the perfect storm of years of underfunding, years of lack of investment combined with the pandemic and high patient demand.”
The doctor said while there was more government support in Scotland than England “It’s still not enough.”
She called for investment in premises which she said were “woefully inadequate” in Scotland and too small to house the allied health staff the government says will help ease the burden on GPs.
But she said even if premises were large enough there is a dearth of allied health professionals to do the work.
“We don’t need to just retain and recruit GPs but all other allied health professionals so we can release time to care for our patients in the best way and make sure we are the expert medical generalists that we should be.”
And she said the government needed to act quickly and “not wait until it all collapses.”
Labor’s health spokeswoman Jackie Baillie called on the Scottish Government to recruit more GPs as a matter of urgency.
She said: “What the pandemic has done is making this simply worse.
“The Scottish Government promised they would deliver 800 GPs and also promised multi disciplinary teams at surgeries. This hasn’t been fully delivered.
“It is critical if we are to avoid further burnout and more GPs the profession the Scottish Government act quickly leaving to support existing GPs and ensure that the numbers are increased and multi disciplinary teams put in place.”
A Scottish Government spokesperson insisted they were making GP services a priority, saying: “We have already delivered a record number of GPs working in Scotland, with more per head than any other country in the UK. We’re committed to further increasing the number of GPs in Scotland by 800, by 2027.
“We are on track to meet that commitment and have also recruited over 2,400 healthcare experts through the GP Contract to support practices.
“Trainee recruitment last year has so far been the most successful year of any of the last five, with 98 per cent of GP training posts having been filled and the offer of a £20,000 bursary as an incentive to increase rural and other hard to fill vacancies.
“The Scottish Government has allocated £360 million of funding over four years under the 2018 GP Contract which reduces current risks to practice stability and sustainability. Further investment will be made in these reforms with recurring funding increasing to £170 million as part of the 2022-23 budget.”