GPs so overworked they risk causing harm, warns RCGP

29 July 2015

GPs so overworked they risk causing harm, warns RCGP

GPs so overworked they risk causing harm, warns RCGP

Dr Maureen Baker, chair of Royal College of GPs, recommends measures to relieve strain on NHS family doctors, amid patient safety warnings.

Britain’s GPs are so tired and overloaded that they are at risk of harming patients’ health by misdiagnosing illness or giving them the wrong drugs, the head of the profession has warned. 

Warning of the risk to patients of “GP fatigue”, Dr Maureen Baker says that “persistent and excessive workload” faced by family doctors puts them at the same risk of inadvertently causing harm or even death as overtired drivers or pilots. 

In a paper for the Royal College of GPs (RCGP), which she chairs, Baker, an acknowledged expert in patient safety, demands urgent action to prevent “devastating” impact on care.

"We currently have no strategies in place to prevent and reduce the risk of patient harm that might arise from having tired, overworked doctors and practice staff.”

Baker’s paper says: “GPs will always work in the best interests of their patients – even when they are putting their own health at risk – but, ironically, this can actually have an adverse effect on patient safety. 

“Few of us would voluntarily board a plane flown by a visibly tired pilot or get on a train where we knew the driver had spent too much time at the controls – yet there are no methods or systems for addressing doctor and staff fatigue in general practice.

“Even in other areas of the NHS, ‘distress signals’ – such as red and black alerts in hospitals – exist so that other clinicians can simply declare that they cannot take on further work safely.

“But unless we disrupt patient services – which is the last thing that GPs want to do – we currently have no strategies in place to prevent and reduce the risk of patient harm that might arise from having tired, overworked doctors and practice staff.”

She sets out five ways in which patients could come to harm from GPs under such strain that their concentration suffers.

They are: missing or delaying the diagnosis of a patient’s illness, which then worsens, or over-diagnosing someone who then receives treatment they do not need; mistaking one patient for another; giving a patient the wrong medication; immunising someone with the wrong vaccination; or failing to issue a patient a repeat prescription, monitor their condition properly or investigate emerging evidence about their illness thoroughly enough.

Her fears mark a worrying escalation of concerns about the ability of NHS general practice services to cope with intensely growing demand, which has been fuelled by a growing and ageing population and a rise in the number of people with long-term conditions such as diabetes, depression and dementia.

Baker said the current GP workforce in England is approximately 3,300 too small, with this shortfall projected to grow to 8,000 by 2020.

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