Overtired GPs openly making mistakes as new research reveals doctors see more patients than is safe

Survey finds GPs working 11-hour shifts and seeing 41 patients a day, on average

Adam Forrest
Wednesday 08 May 2019 00:11 BST
Doctors say they are overworked
Doctors say they are overworked

GPs ​are openly making mistakes because they are overtired, with the majority of doctors seeing more patients than they think is safe, new research reveals.

The study found that one in 10 GPs ​across the UK were seeing twice as many people than they should.

Some overworked NHS practitioners said they struggled to be sympathetic to patients coming through the door. “There is a point where I feel cognitively drained … There is not an iota of empathy left,” said one.

The new survey of 1,681 GPs – carried out by Pulse magazine as part of a new programme for BBC’s Panorama programme – found that GPs are working an average 11-hour day, including eight hours of care and three hours of paperwork.

The poll also discovered that, on average, each GP dealt with 41 patients per day, despite saying 30 was a safe number. One doctor in 10 dealt with 60 or more patients a day – double the safe limit.

When it came to the type of health issues patients had, GPs said 29 per cent of cases were “very complex” and 37 per cent were “fairly complex”. The poll asked family doctors about their experiences on a single day – 11 February this year – when seven out of 10 of the GPs were scheduled to work six or more hours.

Just over 50 per cent said their workload that day was beyond safe levels, but most said it represented a typical day. The data included face-to-face contact with patients, phone and online appointments and home visits.

Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs, is one of those affected by heavy workloads. She said: “In my own practice recently, I had a 12-hour day and 100 patient contacts. GPs across the UK will tell similar stories.”

Nottingham GP Dr Jonathan Harte, who took part in the survey, told Pulse: “By lunchtime, I felt on the edge and risked missing urgent tasks and contacts, thus affecting patient safety. I did miss the fact that a patient I had tried to contact earlier in the day had called back, so I didn’t call her back before the surgery closed.”

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A Hertfordshire GP said: “There is a point where I feel cognitively drained; after about 20 patients, there is not an iota of empathy left.”

Dr James Howarth, a GP in Spilsby, Lincolnshire, said: “I was duty doctor on the day of Pulse’s survey, and I had 124 patient contacts. The median is about 60 to 70 – beyond a safe level.”

He said as well as patient demand, there was a “workload dump” from secondary hospital care. Dr Howarth added: “This workload creates patient safety risks. There are risks around having multiple patient notes open because we’re helping a nurse out with hers, or we’re 30 minutes late so we see the next patient while finishing the notes of the last.

“We might forget consultant details, plans and actions, or prescribe for the wrong person, use the wrong labels on blood tests, and so on.”

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He said in the previous week he sent a blood test using the wrong patient details due to being extremely busy. “I spotted it in time, but how many do we fail to spot?,” he said. “I have raised safety concerns with governing bodies before. I was basically told to shut up or my practice would be run over with a fine-toothed comb.”

Professor Clare Gerada, former chairwoman of the RCGP, said tired GPs were at risk of mistakes, and high numbers of patients added to this. “You could miss a result or misread a letter, or you don’t focus on the right symptom or ask the right question,” she said.

A report in March from the King’s Fund, Nuffield Trust and Health Foundation predicted that GP shortages in England will almost triple to 7,000 by 2023-24. It said the government would miss its target to recruit 5,000 more GPs by 2020 and the only way to cope with the growing workload was to put more pharmacists and physiotherapists into GP practices.

Research from Europe suggests GPs there see 25 or fewer patients per day.

An NHS England spokesman said: “We already know that general practice is under pressure which is why investment in local doctors and community services is increasing by £4.5bn, helping fund an army of 20,000 more staff to support GP practices as part of the NHS Long Term Plan. But we are also aware that almost nine out of 10 salaried GPs currently work part-time.”

Additional reporting by PA

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