Dr Richard Vautrey: Bureaucracy: a health warning

In a new major survey of GPs from across England, 97 per cent of the 3,629 who responded, that’s just over 10 per cent of family doctors in England, say that box-ticking has increased in the past year. Furthermore 94 per cent felt their workload had gone through the roof and 82 per cent say the high level of bureaucracy means they have less time, and fewer appointments, available for patients.

These findings chime with an additional detailed survey of 83 GPs and practice nurses carried out across Leeds. In this almost all believed that the increase in targets for GPs had not improved clinical care, while 69 per cent believed the Government’s most recent contract changes could actually harm patient care.

GP practices in Yorkshire are already suffering from a year-on-year decline in funding while at the same time patient demand is rapidly rising.

The recent contract changes have created an additional and unnecessary workload.

When asked for their views, those GPs in Leeds said that the increasing pressure to chase targets means they have “less time for listening in consultations” and they are “too busy ticking boxes to look after patients properly”.

All GPs aim to provide the best advice and care to their patients and not just on the treatment of an illness or injury, but on how best to prevent ill-health.

But GPs and nurses should be doing this when it is clinically appropriate, not just because the computer tells them to. For example, GPs will use their clinical judgement in advising their patients to increase the amount of exercise that they do but now we’re expected to complete complicated questionnaires that ask patients how many hours they spend gardening, cooking and doing DIY.

And then there’s the new target that requires GPs to encourage healthy people aged 35 to 40 to make an appointment just to check their blood pressure.

GPs understand that this is a very difficult time for the NHS with budgets being cut and pressure to find more than £20bn in savings over the next few years.

This, coupled with rising patient demand and a growing population with more complex needs, means that it is vital we are freed from the bureaucratic burden before patient care in Yorkshire and across the UK is damaged further.

What is equally as worrying as the increased pressures on GPs is the BMA’s national finding that 80 per cent of GPs in the UK say their morale has plummeted in the past year and over half of GPs over 50 are planning on leaving patient care in the next five years.

We have also seen this in our Yorkshire-based survey, with one GP telling us that “all I hear now is GPs planning to retire early”. We simply cannot afford for this to happen.

Despite all of this added pressure, GPs are working harder than ever before, getting through an estimated 340 million consultations a year.

The Government now needs to work with us to find ways of lifting the box-ticking burden, which is putting pressure on already over-stretched GP services, so that we can get back to what GPs do best – treating patients.

We particularly need to see how we can free up more time to meet the challenges from an increasing number of older patients who need co-ordinated and effective care, and to be able to offer the best possible personalised care that all of our patients deserve.

*Dr Richard Vautrey is a Leeds GP and deputy chairman of the British Medical Associaition’s General Practice Committee (GPC).