Practitioner wellbeing and general practice recovery

15 May 2020

Your mental health matters

As we continue to move through this pandemic, attention is rightfully turning to the longer-term impacts of COVID-19 on the public and the NHS.

The stark realities of this pandemic have shone a light like never before on the importance of mental health and wellbeing. 

People have struggled with:

  • continuing uncertainty
  • feelings of disconnection
  • concerns about their health or the health of loved ones
  • the requirement to adapt to the strange new reality we find ourselves in.

We have seen a huge proliferation of the development and roll-out of mental health and wellbeing resources, largely online.

I am hopeful that, with the increased social awareness around the importance of mental wellbeing, we will also see a reduction in the stigma that can be associated with seeking help and support.

Wellbeing resources

In recognition of the specific wellbeing needs of those working in caring roles, this week, the Scottish Government has launched a new online wellbeing hub for those working in the health and social care sector.

This is hugely welcome, and I would encourage you to explore the site, which contains many useful links for different tools to support:

  • individuals
  • teams
  • those in management and leadership roles.

The wellbeing of GPs has long since been a priority of mine, pre-dating COVID-19, and at the College we have consistently called for the creation of a dedicated practitioner health programme to help support clinicians’ mental health and wellbeing.

This call is in recognition of the fact that there is strong evidence to show that doctors delay or avoid seeking help for mental health issues because of concerns around confidentiality and stigma.

Mental health during COVID-19

The Practitioner Health Programme in England, which is now in its twelfth year, has been hugely successful in supporting doctors through ill-health and in returning them to the workforce.

In the context of COVID-19 and the post-COVID landscape, I am all too aware that the risks to mental health will likely increase.

A BMA survey from last month showed that around 40% of doctors are living with depression, anxiety or other mental health problems that relate to or have been made worse by their work.

The survey also found that one quarter of those reporting a problem were not suffering from mental health issues prior to the pandemic.

Support through a dedicated health programme

The need for a dedicated practitioner health service has never been greater and we must not lose sight of this.

We continue to make the case for such a programme to be prioritised in Scotland to ensure that our workforce has the support that we need as we move through this pandemic and beyond.

I look forward to discussing this, among other key issues for our profession when I meet with the Cabinet Secretary for Health and Sport later this month. 

Care and treatment for non-COVID issues

Over the course of the pandemic there has been a great deal of concern about patients not seeking medical attention for urgent non-COVID health problems. 

  • The excess mortality figures compared to this time last year are higher.
  • There has been a significant drop in suspected cancer referrals.
  • Frontline services, such as emergency medicine and general practice, have seen a reduction in the volume of patients accessing their services. 

Some of this may be because patients are: 

  • concerned about the risk of infection in NHS sites
  • have a perception that the NHS is not open for business
  • are concerned that they are burdening the service. 

While some of the reduction in clinical volume is a positive thing and may reflect more appropriate and sustainable use of NHS services (which would ideally continue post-COVID-19!) we have been actively involved in supporting the message that the NHS remains available for those who require care.

NHS is Open

You may have even seen me on your TV screens helping to get this message out as part of the Scottish Government’s NHS is Open’ campaign.

The latest survey results from the Scottish Government suggests that the message is beginning to be heard and there has been an increase in the proportion of people seeking the care that they require – with just over half of those surveyed (51%) stating that they wouldn’t avoid going to their GP practice or hospital at the moment, compared with 41% two weeks before.

The road to recovery

One of the key priority areas that I am involved in just now, is how we recover general practice safely to a ‘new normal’.

I am involved in regular meetings with the BMA, Scottish Government and the other colleges to ensure that the plans are carefully considered across the whole system and accompanied by clear public messaging to manage expectations of what the ‘new normal’ will be.

Our ways of working will continue to feel very different for some time, and we cannot, and would not wish to, return to the intensity of clinical and administrative workload that we had pre-COVID-19. 

Our workload has started to rise again, but the ways in which we deliver care remain changed and are likely to feel very different for the foreseeable future.

Throughout the pandemic, I have also been keen to capture the emerging silver linings for the NHS and ensure that we protect these for the future, and these will be the focus of next week’s blog.

Audio diaries

Finally, you may have heard, throughout the pandemic, various frontline staff sharing their reflections of working during COVID-19 on BBC Radio Scotland’s Good Morning Scotland programme.

I was delighted that this week the light was shone on general practice with two fantastic audio diaries broadcast from our Deputy Chair for Policy, Dr Alasdair Forbes and also Katriona Paterson, Senior Mental Health Nurse, and my colleague at Craigmillar Medical Practice.

Both audio diaries (available from 46:42 and 02:48, respectively) help to promote the innovation and the variety of work that general practice has been undertaking during this time and are well worth a listen.

Huge thanks to both Alasdair and Kat for taking the time to record these! 

Post written by

Dr Carey Lunan, Chair RCGP Scotland

Dr Carey Lunan is a GP partner in one of Edinburgh's Deep End practices and is the current Chair of RCGP Scotland.

Prior to this, she held the role of Executive Officer for Patients and Public and Interface working. She also sits on the RCGP Ethics Committee.

Her priorities during her time as Chair include a focus on practitioner wellbeing, improving the interface between primary and secondary care, and growing and retaining the GP workforce.

She has made tackling health inequalities a high priority and has consistently called for the need to engage the public in a "national conversation" about the realistic role of the modern NHS and the importance of collective social responsibility for its use.

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