Simon Stevens, Chief Executive of UK National Health Service (NHS), announced a five-year plan worth £2.4 billion to aid the GPs i.e., general practice surgeons. The funding plan based on the ‘General Practice Forward View’ will basically fund the appointment of 5,000 more doctors, in addition to thousands of nurses, pharmacists and other related health staff, all by 2020. The initiative came after GPs in the UK from the British Medical Association and Royal College of GPs complained of increasing workload leading to an increase of burnout in the health care sector, which was reaching the point of crisis. The step has been taken “to get general practice back on its feet, improve patient care and access, and invest in new ways of providing primary care”.
“GPs are by far the largest branch of British medicine and as a recent British Medical Journal headline puts, “If general practice fails, the whole NHS fails.” The NHS Head Simon Stevens said, “So rather than ignore these real pressures, the NHS has at last started to openly acknowled them. Now we need to act and this plan sets out exactly how.”
The plan aims to attract and recruit more health care workers and trainees to aid the GPs since in the UK more than 370 million consultations occur per year. As a result, one-third of the GPs in the UK had decided to resign in the next five years and their population had already fallen with only 500 new GPs in the last five years. The plan will support struggling practices, limit the paperwork burden by employing online tools and workload management systems, 100% reimbursement of health care premises and develop strategies to promote team work.
“This is the most significant announcement for our profession since the 1960s,” as told by Dr Maureen Baker, the Chairwoman of the Royal College of GPs, quoted by BBC Health News, UK. “For too long GPs have been undervalued, underfunded, and not recognised for the essential role we play. We genuinely hope that today’s news marks a turning point for general practice.”
The workload of a general physician in the UK is gradually increasing. A review paper published by Dr Bruce Soloway, MD, in the New England Journal of Medicine (NEJM) blog ‘Journal Watch’ has declared that ‘general health practitioners in the UK are being increasingly overburdened with work’. The verdict by Soloway is based on two research papers published in the journal ‘The Lancet’. The reviewed studies “Clinical workload in UK primary care” and “Increases in general practice workload in England” were both published online on the 5th of April, 2016.
According to the review, the workload of the general physician in the UK has increased by 18% since 2007. The paper discusses the current status and reasons for the increase of workload in the UK and the similarities in the situation with the US. Burnout from work is also prevalent in the US health sector though objective data has been sparse. The main objective of the paper was to assess the outline of a general physician’s workload and the British researchers examined more than 100 million electronic records of outpatient encounters to formulate their analysis. The data was recorded from 398 general physicians in England, from 2007 till 2014.
The overall assessment of the situation shows patient-physician encounters per year have increased by 12.4% since 2007. A 6.4% rise in face to face encounters along with double the number of telephone encounters was seen, with an overall increase of 18.2% in both encounters. The numbers for the patient encounters with nurses showed no increase since 2007. On a whole, the number of consultation rates has been increasing in the UK and the English primary care is currently being stretched to its limit. Furthermore, indirect physician activities have still not been documented which are also believed to have increased.
Using context from both of the reviewed papers published in ‘The Lancet’, Dr Soloway said, “Despite major contextual differences between the US and the UK, primary care faces similar challenges on both sides of the pond. An editorialist notes ‘a seemingly endless demand’ for clinical care, coupled with ‘more complex patient care, escalating administrative tasks, pressures to meet quality performance targets, and rising documentation requirements.’ The study authors call for expansion of the primary care workforce and suggest that the perception of general practice as ‘stressful, work-pressured, low-status… with excessive administration’ must be changed before physicians will view general practice to be to a career choice with status and reward.”
Burnout in the American workforce is becoming a phenomenon of immense importance. Some call the condition the Burnout Syndrome; however, the official scientific backing for a definition is still missing. The multifaceted definition for Burnout favored by a majority of researchers is based on three different dimensions which are: de-personalization, emotional exhaustion and diminished personal achievement.
The World Health Organization (WHO) has recognized some characteristics as symptoms of burnout and on the basis of these symptoms we can categorize the prevalence of burnout. According to the WHO, the symptoms of burnout include:
- Increasingly developing cynicism, sarcasm and criticism at work
- Lack of motivation and diminished performance
- Difficulty in coming to work and lack of energy which affects productivity
- De-personalization i.e., losing personality traits and developing irritability and losing patience
- Increase in self-medication either with drugs or even alcohol
Occupations in the health care sector e.g., doctors, nurses etc are known to have above average burnout rates in the US. Research has further shown physicians in the US suffer 10 times more from the burnout syndrome than the rest of the population. It is estimated more than 45% of American physicians suffer from burnout, which can leave negative impacts on their personal life, along with increased chances of developing substance abuse or committing suicide.