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Protecting the health of GPs

Dear Colleague,

Plans for a national occupational health servicefor GPs suffering from burnout and stress were outlined by NHS England chief executive Simon Stevens last week.

The new service is scheduled to start on 1 April 2016 – part of a £5m initiative to improve the health of NHS staff.

It will provide specialist support and build on a number of existing, successful programmes highlighted in the announcement: the Practitioner Health Programme in London; House Concern, a specialist service in the North; the Somerset Clinician Support Service; and MedNet – a service provided by South London and Maudsley NHS Foundation Trust.

This announcement follows intense lobbying by the BMA for more than two years, including a joint letter I wrote with BMA occupational health committee chair Paul Nicholson to the Department of Health in January 2014, and a subsequent letter to Simon Stevens last November.

At a time when general practice is under unprecedented pressure, which is affecting the physical and emotional health of GPs, we have cautiously welcomed this as a positive first step, but we would need to see further details and specification for the service – read about the BMA response. We need a comprehensive service – not just for burnt-out doctors These proposals, however, do not go far enough. GPs should be offered a comprehensive service – not just one for stressed or burnt-out GPs – but for all GPs, with the full range of occupational health support that is afforded to other doctors in the NHS.

We will continue to lobby for this, given it is just as important to prevent ill health as it is to treat it, and services that meet the unique needs for the provision of GPs, who may at times have concerns about seeing other local GP colleagues. GP staff must be included The proposal makes no specific mention of staff working in GP practices – and we will argue that they deserve the same access to occupational health services as other NHS workers. Our staff work in extremely pressurised environments, like us trying to cope with demand well beyond their capacity. There is strong evidence that access to high-quality occupational health services keeps staff at work, and mitigates the high costs that can result from sickness absences. Ultimately, in the NHS good occupational health services can have a direct positive impact on patient care.

The GPC will continue to engage with NHS England as more detail unfolds, and continue to lobby for specialist-led occupational health services for all GPs and practice staff. Improving access is not about increasing opening hours Last week I spoke in a panel discussion at NHS England‘s Health and Care Innovation Expo on 'Improving access to general practice'.

I made the point that access is not about simplistically extending opening hours, but about patients being able to receive appropriate care and services at the right time. For an older housebound patient, access could be about receiving a district nurse in a timely fashion, or a GP to visit them when they may have a chest infection – the latter being undermined if GPs are diverted into sitting in surgeries superfluous to need, open for seven days.

Access is also about practices having adequate non-clinical staff, for example, to handle increased volumes of phone calls and footfall in reception – a neglected area of investment by Government. And in the current environment of inadequate capacity, access must be about reducing avoidable demands on GPs so that we have more time and appointments for patients who need to see us. This involves reducing bureaucracy, and ending unresourced and inappropriate workload shift from other parts of the system. Influencing policy makers Over the past two weeks, I have had the pleasure of hosting a series of GPC stakeholder roundtable events held at BMA House in London to discuss with a range of leading health partners the future of general practice, and in particular the new models of care.

Guests included Simon Stevens and other senior officials from NHS England, members of the Department of Health, chief executive of the King's Fund Professor Chris Ham, chief executive of the Nuffield Trust Nigel Edwards, Professor Martin Roland who authored the recent Workforce Commission on Primary Care, and also representation from Health Education England.

We were also grateful for the presence of a number of LMC colleagues, which highlighted the unique role of the GPC/LMC infrastructure as being the representative voice and perspective of grassroots GPs that the NHS depends on – and without whose engagement, change will not be deliverable. These meetings will feed into the GPC statement on the future of general practice to be published in the autumn.

It was good to note that so many GPC members – around one third listed – featured in the Pulse top 50 list of most influential GPs, endorsing the important role of the GPC as the leading voice of GPs in the UK.

As always, you can keep in touch with the latest news at

With best wishes,

Chaand Nagpaul

BMA GPs committee chair

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