UK

GPs ‘should be treated like pilots because working full-time may be dangerous to patients’

GPs need to be treated like pilots because working too long could be dangerous, the country’s top doctor said today.

Professor Martin Marshall said pilots only fly 32 hours per week because they’re in a ‘safety critical occupation’.

The same understanding is needed for doctors to avoid incorrectly diagnosing patients or prescribing them the wrong medication, he said.

It follows a growing row over a lack of face-to-face appointments, which are still below pre-pandemic levels.

Health chiefs have now stepped in and threatened the worst performing surgeries with being named and shamed unless they start seeing more patients in-person.

GPs reacted with fury, saying the plans would trigger a wave of retirements and ‘sink the ship altogether’.

But patient rights campaigners have said they need to work amid a wave of doctors seeking part-time roles.

It comes as data from a Government-backed study this week revealed the average GP — who earns around £100,000 a year — was working just 6.6 sessions each week before Covid, down from 7.5 sessions a decade ago.

Discussing the issues today at the Royal College of General Practitioners’ (RCGP) annual conference in Liverpool, Professor Marshall said making doctors work longer hours is ‘just a complete nonsense’ and would risk patient safety.

Discussing the issues today at the Royal College of General Practitioners’ (RCGP) annual conference in Liverpool, Professor Marshall said making doctors work longer hours is ‘just a complete nonsense’ and would risk patient safety. Pictured: Professor Marshall speaking to MPs last month on the Health and Social Care Committee for tackling the Covid backlog 

The average number of sessions GPs works in a day have gone down over the last decade while their wage growth has gone up. In 2012 the average GP worked 7.3 sessions a week but this has now fallen to 6.6 a week, the equivalent of just over three days of work a week. In the same period the average GP income went up by more than £6,000. A GP’s daily work is divided into sessions. According to the NHS, a full-time GP works 8 sessions a week, formed of two sessions a day, generally starting at 8am and finishing at 6.30pm, though these hours can vary

The average number of sessions GPs works in a day have gone down over the last decade while their wage growth has gone up. In 2012 the average GP worked 7.3 sessions a week but this has now fallen to 6.6 a week, the equivalent of just over three days of work a week. In the same period the average GP income went up by more than £6,000. A GP’s daily work is divided into sessions. According to the NHS, a full-time GP works 8 sessions a week, formed of two sessions a day, generally starting at 8am and finishing at 6.30pm, though these hours can vary

He told the conference he had a ‘very unpleasant conversation with a senior Conservative Party politician’ last week, who asked why he doesn’t tell GPs to work harder.

Professor Marshall said: ‘After I’d picked myself up off the floor, I pointed out to him that forcing people to work more days in a week, when they’re already feeling vulnerable – and they’re already concerned that the pressures of the job are going to risk them making diagnostic errors and prescribing errors – is just a complete nonsense.

UK’s Covid cases rise by 8% in a week to 44,932 and hospitalisations tick upwards but deaths fall by 3% 

Britain’s daily Covid cases rose again today and England’s outbreak is now the biggest it’s been since January, according to official figures that add to fears of a difficult winter ahead.

Department of Health bosses posted 44,932 infections, a spike of eight per cent on last Friday. It was the tenth day in a row cases increased week-on-week.

Meanwhile, the number of people being admitted to hospital with the virus also rose, with 827 Covid patients seen on Monday, the latest date data is available for. It was a rise of 6.3 per cent on the week before.

But the number of people dying with the Covid fell today. Some 145 victims were recorded, down 3.3 per cent on the 150 posted last Friday.

The damning figures come after separate official data showed Covid cases in England are now at their highest level since January, with one in 60 people infected on any given day last week.

The Office for National Statistics (ONS) estimated 890,000 people in England – 1.63 per cent of the population – had the virus on October 9, up 13.2 per cent on the previous weekly figure. 

Infections have not been as high since the country began to recover from the darkest days of the second wave in mid-January, when more than 1million people were thought to be carrying the virus.

Cases now appear to be rising in all cohorts, apart from those aged 35 to 49, where the ONS warned the trend is uncertain. But the latest hike has been fuelled by infections among pupils, with one in 12 youngsters aged 11 to 16 infected.

Meanwhile, separate data from the UK Health Security Agency, which took over from the now-defunct PHE, today showed the the R rate is the same level as last week – between a range of 0.9 and 1.1. 

 

‘Pilots fly for 32 hours a week, and they do that because they’re in a safety critical occupation.

‘We’re in a safety critical occupation as well, and we need the same understanding.’

Data from a Government-backed study this week revealed the average GP — who earns around £100,000 a year — was working just 6.6 sessions each week before Covid, down from 7.5 sessions a decade ago.

Dr Becks Fisher, a GP and senior policy fellow at the Health Foundation think tank, told the conference the NHS needed to improve how they counted GPs and measure their working patterns to ‘shift the narrative’ around doctors working part-time.

‘Our workforce numbers are currently a bit of a shambles,’ she said.

The British Medical Association, the trade union for doctors, argued the notion of a ‘part-time GP is often anything but’. It said the average doctor still works 40 hours per work — just split into fewer sessions, and the current levels of workload were made worse by ‘piles of admin and bureaucracy’.

Dr Richard Vautrey, BMA GP committee chair, dismissed the notion that GPs work part-time because 40 hours is ‘the same as most full-time jobs’.

But campaign group Silver Voices, which represents elderly Britons, called on ministers to take ‘control’ of the hours GPs are working and blamed the drop in sessions they worked as a reason patients were struggling to see their GP in the flesh.

Professor Marshall’s comments echo those he made to ministers earlier this month, when he warned the model of a full-time GP is ‘probably something we won’t see again’.

He told a Health and Social Care Committee on tackling the Covid backlog last month that GPs who work three days are ‘pretty much’ working full time, because they work for 11 to 12 hours.

He warned GPs are working under ‘intense pressure’, which is ‘increasingly impacting’ doctors ability to provide safe care.

If doctors are forced to work four-day weeks and ‘start making diagnostic errors or prescribing errors, that’s no good for anybody’, Professor Marshall said at the time.

He added: ‘So while general practice is under pressure, there are very few people who feel that they are able to work full-time.

‘And secondly we have to accept the reality that the younger generation, of clinicas of all sorts, want career portfolios, they want mixed careers, they don’t want to work full time.

‘So the model of a full time GP I think is probably something we won’t see again.’

Before the pandemic, around 80 per cent of GP appointments took place in-person. In a bid to control the spread of the virus, around half of consultations took place virtually or through a phone call.

The number of GP appointments taking place face-to-face tumbled at the start of the pandemic when surgeries were told to see patients remotely where possible. But despite vaccination rates it is yet to climb back to pre-pandemic levels. The above graph shows the number of face-to-face GP appointments (red line) by month since the end of 2019

The number of GP appointments taking place face-to-face tumbled at the start of the pandemic when surgeries were told to see patients remotely where possible. But despite vaccination rates it is yet to climb back to pre-pandemic levels. The above graph shows the number of face-to-face GP appointments (red line) by month since the end of 2019

Just 0.6 per cent of appointments in August were home visits, down from one per cent before the Covid crisis. Doctors have long called for them to be scrapped because they are too time-consuming

Just 0.6 per cent of appointments in August were home visits, down from one per cent before the Covid crisis. Doctors have long called for them to be scrapped because they are too time-consuming

But despite Covid restrictions being lifted during the summer, less than half of GP appointments in July and August were face-to-face.

In a bid to push through more face-to-face appointments, Health Secretary Sajid Javid threatened to name and shame the surgeries failing to deliver them in enough numbers.

The RCGPs immediately hit back, criticising the plans as ‘unfair, demoralising and indefensible’, while other unions warned it could trigger a wave of retirements and ‘sink the ship altogether’.

But Silver Voices said the response by GPs had a smack of ‘we know best’.

Dennis Reed, head of the campaign group, said the Government had been pushed into its tough stance because doctors had ‘ignored’ patients’ wishes by trying to keep people getting checked over the phone.

He told MailOnline: ‘They’re ignoring patients and patients’ views. Older people understand their aged bodies all too well and older people are often the best judges as regular users of the health service as to whether a GP appointment is needed.’

The chief executive of the Taxpayers’ Alliance, John O’Connell, said patients must be able to see their GP face-to-face given the huge amount they pay for the NHS.

And some took to social media to accuse their doctors of being ‘overpaid’, adding they had ‘never seen a poor GP’.


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