Another GP here.
12 hour day yesterday, mostly (>60%) speaking to people having mental health crises, yet still expected to deal with it all in 10 minute intervals. I was absolutely exhausted by 2pm, and then carried on for another 6 hours. I stopped when I could no longer focus on the computer screen, not because the work was done.
I'm lucky to have great colleagues, and I want to be able to provide a good service for our patients, but I've already burned out (in another, chronically understaffed, practice pre-pandemic), and I can feel myself sliding back into that feeling. I'm back to waking up at 4am every morning, worrying about what I've missed/ done wrong due to the overwhelming amount of work. We're all struggling with the ongoing tsunami of (appropriate) healthcare demand.
I am sick to death of hearing 'GPs aren't seeing anyone' (especially from hospital staff who should really bloody know better) when I'm making 150-200 clinical decisions per day (telephone, F2F, e-consults, non-routine prescription requests, abnormal blood results, other staff's queries). All the straightforward/routine stuff is dealt with by ANPs/Pharmacists/ Practice Nurses, so the cases I see are largely really complicated or potentially serious.
I would love to see more than the 40-50% F2F I'm currently seeing, as I find it much easier to clinically assess in person, but there simply isn't space in the building to socially distance with any more patients.
Our practice took 14,000 incoming calls in March '21. We have approximately 20,000 registered patients. There was a 4-6 hour call queue at some points. Many of these patients are genuinely very unwell, and waiting lists for everything, from surgery, to physio, to mental health services, are so long as to make referrals meaningless. On top of this, hospitals are pushing a lot of un-funded work into primary care, lots of 'can the GP please...' in the discharge or clinic letter, particularly when outpatient clinics are happening by phone. When we say that the workload in general practice is unmanageable, this is what we mean.
I also do shifts as a primary care Dr in a city centre A&E. It's very busy, but nowhere near as complex, or as clinically risky, as a GP day. When GPs direct people to A&E after a telephone call, it's because we simply cannot see all of them, so we have to manage the clinical risk as best we can, by sending in the people who are going to need intervention in order to find out the problem. Remember that we have no same day bloods/imaging, and it's very easy to say there wasn't much wrong with a patient once you've got normal bloods and XRs, and have observed them for a couple of hours. For every person that we send in, there are dozens more that we are dealing with in the community. People also often lie about having spoken to their GP, or exaggerate their symptoms on the phone so that they're dealt with quicker. We can't be held responsible for this.
General Practice has been underfunded, understaffed and haemorrhaging clinicians for over a decade now. We get the same money as A&E gets for two patient attendances, to provide unlimited access to a patient for a whole year. The average number of GP consultations (pre-pandemic) per person per year in England was 6. In our practice (deprived area) it was 7.5. That's actual consultations, so not counting all the background admin, prescribing, dealing with correspondence etc.
Anyway, I'm ranting now, so will stop. Suffice to say, the GP bashing from all sides is affecting morale in the face of overwhelming workload, and we will lose even more GPs before this is over.