Talk of GP burnout is never far from the headlines. Talk of more than half of GPs looking to leave the profession, many citing problems with workload and burnout, dominate the media. Stats back up the fact that burnout is a big problem too. Incredibly, more than a thousand GPs sought professional help from the NHS GP Health Service in one year, following its formation in 2017. Most cases involved stress, anxiety and depression.
Dr Euan Lawson is author of Wellbeing: Combatting Burnout in General Practice, Director of Community Studies at Lancaster Medical School and a practising GP. Commenting on the problem he said: “Worryingly, half of GP leavers are younger than 50 years old and 77% of those planning on switching careers are younger than 55 years old. It seems that GPs are burning out quickly and burning out young.
“Nearly half of the current workforce is committed to leaving general practice or considering doing so in the near future.”
Clear symptoms and causes
A quarter of GPs feel that work stress has made them unwell in the past year and almost a third do not see themselves continuing to work in GP practice for another five years. Burnout symptoms include feelings of detachment and lack of empathy towards patients while some GPs become workaholics, suffering from anxiety and depression.
Factors leading to burnout include:
- increasing workload, with more appointments as the population ages. The average person now sees their GP over five times a year
- shorter appointments, making it difficult to deliver high quality care
- negative media portrayals of GPs as overpaid and demanding
- increasing dependence of patients on doctors in the absence of traditional support networks – with one patient asking her GP to change TV remote control batteries
- rising patient expectations, leading to more complaints
“The effect of these many different stressors on GPS has been likened to the effect of rising water temperatures on a boiling frog,” said Dr Lawson.
The technology solution
There’s no doubting that burnout is a problem. So what are the solutions?
Dr Lawson points to involving other health professionals in primary care, including social workers, mental health nurses, physiotherapists and pharmacists and, interestingly, changing working practices through the use of technology.
The idea of tech as a solution to the burnout problem is high on the NHS agenda at the moment. In early February Health Secretary Matt Hancock told the Royal Society of Medicine: “I care about tech because I care about people. I care about our NHS staff and our NHS patients. And I care about getting this right. Because I know the consequences when we don’t.”
Hancock was talking at the launch of the Topol Review, which is all about preparing the healthcare workforce to deliver the digital future. It put forward a number of ideas of how tech can be used to improve the NHS, including the reduction of workload pressures.
One idea revolved around Artificial Intelligence (AI). Some patients are already using AI technologies through their smartphone to monitor and manage their health: AI-powered chatbot technologies that use computer intelligence to provide patient and clinician-friendly interfaces for monitoring an individual’s health. AI technologies will also allow patients to self-monitor conditions presenting with direct or translatable visual signs. Clinicians and patients will benefit from smarter triage, which will reduce the volume of clinical workload and free up time for patients with the greatest and most immediate need.
This is just one example of how technology is viewed as the best medicine when it comes to reducing workload while improving patient care. And it seems the face-to-face GP consultation may be in the process of becoming an anachronism. Telephone and Skype consultations are now commonplace, and the new NHS England app will include built-in support for GP video consultations.
Advocates of online triage, symptom-checkers and consultation tools are growing too, while expansion of virtual practices looks set to continue. Crucially, the use of technology to manage the number of face-to-face consultations has support across the board, from the BMA and RCGP to the UK’s four governments. It’s also the second of Hancock’s stated priorities, after workforce.
That said there’s no shortage of critics of the use of technology – and it will only ease the workload pressures if the technology is effective, reliable and matches the demands of smartphone-wielding patients. This Practice Index article discusses the topic in more detail.
Other ways technology can help reduce workload and avoid burnout include digital dictation and speech recognition – there are plenty of case studies available highlighting the timesaving benefits – while smart device technology is aiding patient care while saving GPs time. Digital workflows and scanning can also reduce admin time.
Dr Chaand Nagpaul, writing for the BMA blog, said EMIS mobile – the software that’s loaded on to a tablet and wirelessly downloads the patient’s clinical data from the EMIS clinical system – is an effective timesaving tool.
“Systems such as this provide a scaled-down but comprehensive version of patients’ medical records on the tablet during a home visit, including data on consultations spanning the past year, investigation results, medication, details of referrals, major alerts, quality and outcomes framework reminders, and even hospital letters.
“I now record consultations on the tablet while seeing the patient, and with a keystroke this is synchronised wirelessly into the practice clinical records in real-time. No more going back to the surgery to type up the consultation or calling the patient back because I didn’t have the vital information during the visit. The scenario is all the more advantageous when visiting multiple patients in care homes.”
Dr Nagpaul continued: “Not only has this significantly saved on time and work, but has the added clinical-governance benefit of managing patients more effectively and safely with access to their medical records. It has information-governance advantages of no longer carrying around pages of confidential patient data, and allows contemporaneous remote recording of my clinical entry into the patient’s records while visiting a patient.”
Technology, when effective, reliable and safe, can contribute towards easing the problem of workload and burnout. Given technological developments and Matt Hancock’s focus on all things digital, the use of tech by GPs will only grow. As Dr Lawson commented, by combining tech and the involvement of other health professionals in primary care, workload pressures may well be eased.
Finally, it’s not just GPs that are struggling with burnout – it’s a very real problem for practice managers too. For more on this, click here.
Do you think technology is the answer to easing workload pressures? What works for you? What doesn’t work? What are the barriers to digital transformation? Let us know by commenting below or take it to the Practice Index Forum.
Co-written by Courtney Castle from VoicePower Ltd. VoicePower supplies speech-recognition solutions and dictation products to the healthcare sector.
Topics trending in the forum:
- DSP Toolkit
- Staff with personal issues at work
- NHS experience essential?
- Prescribing for patients declining monitoring
- Business banking switch