There has been an “extraordinary” increase in abuse aimed at GP teams, which is contributing to family doctors leaving the profession, one of England’s leading medics has suggested.
Dr Claire Fuller, primary care medical director for NHS England, told the PA news agency it is not acceptable to “bash” GPs, who are “exhausted” and working “flat out”.
She also said collective action by family doctors – which has been ongoing since August – has been like “holding up a mirror”, with hopes that the health service will learn from the changes it has triggered.
Dr Fuller said: “When you talk to GPs about why they leave, they say one is about the workload and the other one is about respect.”
She said “from the respect point of view” the “increase in violence to members of primary care teams is extraordinary that has happened, from attacks, both physical and verbal”.
Dr Fuller added: “So if you think about practice managers, every day, will get a phone call from a patient that says, ‘if I die today, it’ll be your fault’.
“And these are people that are working part time, on low incomes, that are receiving this level of abuse from the public.”
Dr Fuller also spoke of “a constant narrative that GPs are not doing what they should be” in the media.
“Yet the evidence we’re getting is the experience is improving,” she added. “So it has now become acceptable to bash GPs, and that’s not OK.”
“I’m hearing that from every GP I speak to. And people do leave because they’ve just had enough.
“It does matter when you keep reading in the press what a terrible job you’re doing when you’re exhausted and you’ve worked flat out and you haven’t had any lunch – people are working really hard, and something has happened that has changed in that narrative.”
However, Dr Fuller said there have been improvements in general practice emerging.
“There’s variation, but actually we’re starting to see improvement around the country,” she said.
“Not only have we got more GPs, fewer GPs leaving, but we are also starting to see that patients’ experience of access is starting to improve.
“It’s not perfect everywhere. We still need to make it better, but it is starting to get better.”
She also told PA that collective action by GPs, which has been ongoing for six months, has been “really interesting”.
Collective action means GPs can stop or reduce certain work as a way of collectively expressing concerns, although it is not the same as a strike.
The move was announced by the British Medical Association (BMA) in August, with the union issuing a list of actions for surgeries to choose from.
This included GPs stopping engaging with the e-Referral advice and guidance pathway, which allows a clinician to seek advice from another, unless it is “a timely and clinically helpful process”.
The BMA said the pathway “can lead to lengthy back and forth discussions with further requests for GP actions”.
Speaking of advice and guidance, Dr Fuller said: “Say you want to do a neurology referral, and the waiting time may still be quite long, you may do an advice and guidance to get some advice back from the consultant to help support that patient while they are waiting.
“You’re going to still carry on doing that, because that’s in the interest of your patient.
“So one of the things [collective action] has done, it’s accelerated the primary secondary care working.
“So getting GPs and consultant colleagues back in rooms to talk about the pathways that aren’t working. So bizarrely, that may be one of the positive legacies that comes out from it.
“It has been a bit like holding up a mirror for the bits that in your system where it pops up, and in some systems where it has had less impact than in others, which will probably reflect underlying positions.”
She added that it is “important” to look at the actions that were taken by surgeries during collective action, as well as the impact it had.
“Actually, not all the learning from it has been bad,” Dr Fuller said.
“I would want the primary secondary care conversations to be continuing. I would want GPs to be talking with consultant colleagues about which of the advice and guidance pathways work.
“There’s an element of, actually, ‘it was a point in time and it triggered a change’. I would want us to still continue to benefit from the changes that have happened.”
Dr Fuller was speaking at a consultation event for the upcoming 10 Year Health Plan in Liverpool.
The blueprint will focus on shifting more care from hospital to the community, as well as preventing ill-health and a greater use of data and technology.
More than 300,000 women have had pharmacy consultations for the contraceptive pill following the launch of a scheme in April 2023 (Tim Ireland/PA)
She said that “all members of primary care” will play a “massive role” in those shifts.
It comes as new NHS figures revealed more than 316,000 pharmacy consultations for the contraceptive pill have been carried out since a scheme launched in April 2023.
Dr Fuller said: “Contraception is terribly important, as we know. And for many women, contraception is an incredibly important part of just our day-to-day lives, and we need to make it just as easy as possible and not over medicalise something that it should be part of just how you live your life.
“So actually, being able to go to the community pharmacies who are open at weekends with longer opening hours, so they don’t have to take time off work to get an appointment or to phone and go by the GP, just makes it easier for people to live their lives in the way that works for them.”
Dr Fuller expects the number of women taking part in the scheme to increase in the future.
“I think it’s very much word of mouth spread through different communities, so I expect it to continue to grow,” she said.