GPs 'Too Exhausted' For Out-Of-Hours

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BMA poll finds 64% of GPs in Wales are too tired from daily pressures to provide the service

Exhaustion is preventing GPs in Wales from providing Out Of Hours services, according to a poll by the British Medical Association.

The survey saw 64.3 per cent of doctors citing tiredeness caused by daily pressures as the main reason stopping them from working outside of their daily hours.

38.1 per cent also said rates of pay for the work were 'unattractive'.

GPs have been able to opt-out of providing Out of Hours services since 2004.

The survey carried out this winter involved 100 GPs and found 57% say they are involved in out-of-hours work.

Among GPs who did not work out-of-hours, exhaustion caused by the daily pressures of general practice was the most common reason - with more than 60 per cent of respondents citing this as a factor.

More than a third of GPs (40.5 per cent) said they simply 'don't want to' work out-of-hours. 

The BMA Wales survey also asked GPs what action should be taken following the implementation of HMRC guidance following Health Boards in Wales making changes to the taxation status of doctors who work Out of Hours.

Health Boards now consider these doctors as being "employed" for taxation purposes only and not for employment rights purposes.

This means that GPs are not entitled to benefits such as annual leave, study leave, sick leave or maternity leave - creating a further barrier to out of hours working. 

Responding to the survey results Dr Charlotte Jones, Chair of GPC Wales said, "These results aren't surprising and confirm what we have known for some time. The pressures that GPs face day in, day out are leaving them exhausted.

"This exhaustion can ultimately lead to burn out and GPs leaving the profession early, further compounding the problem.

"The system as a whole is under a sustained amount of intense pressure, brought about by an increase in workload and inadequate resources due to years of underinvestment.

"This is a significant problem facing in-hours services but is particularly acute for out of hours services, meaning out of hours is viewed as an unattractive place for GPs - who despite everything continue to provide high quality services for their patients - to work. 

"Changes to HMRC regulations and the way each Health Board is implementing the changes has led to GPs who do work out of hours feeling undervalued and not appreciated. 

"If a person is considered employed for taxation purposes, then they should be considered employed for all purposes and should receive the same benefits as others who are employed such as paid annual leave and sick leave.

"True investment is needed in out of hours services to ensure patients receive a safely staffed service. 

To ensure that Out of Hours services are fit and prepared for the future it needs to be made an attractive place for GPs to work.

"This can be achieved by tailoring offers to the needs of individual GPs - providing increased pay rates or a full or zero hours contract depending on the needs of the individual doctor.

"Above all, GPs who work out of hours need to be feel that they are a valued member of the workforce. 

If urgent action is not taken patient care will be impacted.

"Services will continue to be inadequately staffed, and in some cases not staffed at all, which will lead to longer waiting times; reduced appointment availability and a need for patients to travel longer distances to access care.

"One of these issues alone would have an impact but together will inevitably add considerable pressure onto colleagues in practices, secondary care and the ambulance service. "

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