GPs losing sleep over patient safety fears, says head of profession

Prof Helen Stokes-Lampard, chair of the Royal College of General Practitioners, says colleagues are left anxious by overwork and exhaustion

“Shattered” GPs are lying awake at night worrying they may have harmed their patients by making mistakes caused by tiredness and overwork, the leader of the profession has revealed.

Family doctors are losing sleep because they are so anxious that they have put patients’ safety at risk by missing a symptom or not keeping their medication up to date, said Prof Helen Stokes-Lampard.

The doctor, who is the chair of the Royal College of General Practitioners (RCGP), told the Guardian: “GPs, like many caring professionals, never completely leave their jobs behind when they go home; it’s a 24/7 responsibility.

“However, the situation for GPs has deteriorated and I know of GPs who have told me that they have sleepless nights worrying about their patients, or that they’ve missed something because they’ve been constantly up against it all day long, working in ways that don’t feel safe.

“The ones I’ve spoken to are women in their 30s and 40s, but I’ve heard anecdotal stories about other colleagues as well,” she said. GPs have told her how they are still awake at 3am or 4am wondering if, as a result of being under constant pressure, they have made errors.

Stokes-Lampard said GPs were struggling to keep up with rising demand for consultations, giving patients as much time as they needed in appointments and a relentless flow of correspondence from hospitals about the latest developments about patient.

“GPs are professionals’” she said. “We do everything we can to be meticulous; that’s in our nature and is part of our training. But when you’re shattered, it is possible to overlook a changed prescription request, or not update a patient’s record as comprehensively as would be ideal – things that can impact on patients’ health further down the line.

“But there are also more sinister things we worry about. Did I miss a symptom of something that could be more serious? If I’d had more time with that patient, would my eventual diagnosis have been different? These things play on your mind, and it isn’t healthy.”

Despite the anxiety, actual errors were rare, said Stokes-Lampard, a GP in Staffordshire. “Most of the time, of course, we haven’t missed anything, but when the seed of doubt has been planted, it’s hard to get it out of your head.”

The RCGP’s annual conference in Liverpool this week is expected to hear vocal warnings from GPs about their workloads and calls for urgent government action to tackle the profession’s worsening staff shortages. Jeremy Hunt, the health secretary, is likely to face tough questions when he addresses the gathering on Thursday.

Stokes-Lampard said: “It isn’t just the hours in clinic I’m talking about. It’s the urgent duties we have to perform long after our patients have all left the surgery: prescription reviews, hospital letters and ensuring records are up to date. These might seem like routine administrative tasks but they have a major impact on the delivery of high-quality patient care, and the more fatigued we are, the more room there is for error.

“GPs are trying to do more and more, but worn-out doctors are no good to anybody and there is a limit beyond which we cannot guarantee that we are practising safely.”

She said family doctors were suffering from physical and emotional exhaustion because workloads had grown by an estimated 16% over the past seven years, but investment in GP services had fallen over the past decade. “We know GPs are burning out. The GP health service was launched earlier this year and there are already more than 500 GPs on its books,” she said.

In 2015, the Conservatives pledged to increase the number of GPs in England by 5,000 by 2020 to tackle growing shortages caused by family doctors retiring early and too few medical graduates choosing that branch of medicine as their career. But numbers have fallen over the past year, record numbers of surgeries have been closing and NHS England has had to increase its recruitment of foreign GPs from 500 to between 2,000 and 3,000 in order to help meet the 5,000 target.

Stokes-Lampard’s remarks come days after the British Medical Association warned that GP practices might have to start turning away new patients because they could not cope with the demand for appointments caused by the ageing and growing population.

The Department of Health said: “GPs are the absolute bedrock of the health service, which is why we have committed to an extra 5,000 doctors in general practice by 2020, are investing an extra £2.4 billion into the sector in real terms every year, and are helping practices reduce their workload, free up GP time and improve care.

“We know working in general practice is challenging, and we are also helping GPs to prioritise their mental health through a £16m programme of free confidential advice and support.”


Denis Campbell Health policy editor

The GuardianTramp

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