Last week, I found myself immensely saddened and increasingly angry on hearing the results of a new survey of NHS GPs. As a doctor, and as a human, it’s heart-breaking to learn that 24% of GPs know a colleague who has taken their life due to work pressures.
But this isn’t news to me; in fact, I’ve spent years of my life trying to help relieve clinicians of some of these unsustainable and mentally draining pressures. The lack of progress on tackling these issues on a national level remains woefully inadequate, and - as things stand - the situation looks unlikely to improve.
Suicide is a complex phenomenon; it’s not possible or helpful to look for simplistic correlations between a person’s professional experiences and their decision to take their own life. However, the most recent HSE statistics identify health professionals as having some of the highest rates of work-related stress, depression or anxiety. For GPs, I believe that the unique set of conditions under which they work puts them at even greater risk.
GPs are right at the front of the NHS frontline - acting both as the ‘first line of defence’ and the gatekeepers to the myriad treatment pathways. They juggle a huge volume of diverse and complex patient cases - often whilst simultaneously handling the day-to-day practicalities of running their practices.
Stress is compounded by a very real threat of violence from patients, with physical attacks becoming terrifyingly regular in the primary care sector. Without doubt, GPs do a difficult, impressive and laudable job. And too often, this is a job they are left to do in isolation.
The systems and communication channels that are supposed to ‘support’ primary care practitioners to deliver patient care most often prove worse than useless. I’ve seen this first hand: long email chains, paper referral forms and missed phone calls are a normal part of a GP’s day.
What’s more, when they are given access to digital tools, they are typically confusing to use, prone to crashing, and poorly integrated with NHS systems and patient records. This means that information is lost, knowledge is trapped and patients fall through the cracks. Clinical time is being eaten up by badly designed systems and outdated ways of working. This means that no one can benefit from the collaborative style of care that delivers the best outcomes. It’s no wonder that GPs frequently feel helpless, frustrated and undervalued.
GPs enter the speciality because they are committed to helping their patients and supporting their communities. I know that it’s a huge blow to my colleagues in primary care - as it is to all doctors - when they find themselves without the time or resources to give every patient the care they need. Often, the weight of feeling that they have ‘failed’ can be too heavy to bear.
We can’t go back and help my colleagues in the NHS who we’ve already lost to suicide. But we can, and we must, push for system-wide changes to the status quo that continues to put their colleagues at higher risk. The time for targets and big promises is over; now it’s time for action. This must be initiated and championed by those at the top - the NHS decision makers and politicians with power and budgetary control.
First, we need to replace clunky, outdated systems with specially-designed digital tools that actually save time and reduce stress. Then we need to look at new ways for clinicians and care teams right across the NHS to work together to deliver services and secure successful outcomes for patients. And then, we need to build new pathways for the public to engage with the NHS, so GPs are not overwhelmed with demand.
For the sake of our primary care teams, and for all of us who depend on them, these changes cannot come quickly enough.
Dr Owain Rhys Hughes is the founder & CEO of Cinapsis