Pressure from all sides
Nobody likes to receive a complaint about themselves or their colleagues, particularly from the General Medical Council (GMC), and the bad news is that complaint levels are at an all-time high. According to the univadis GP News service, "the GMC received the highest ever number of complaints in 2011, with nearly half being lodged against GPs" (click here). It further states that "GPs attracted 47% of the complaints, despite making up only 24% of the register".
The reasons are many and complex, but could include a public that is more aware of its rights and has greater "consumer" expectations, with people more ready to make complaints while at the same time less willing to tolerate medical and system errors. Of course, there is always room to improve standards, but I do not think that a deficiency of professional standards within the medical profession plays a significant role in this trend. This is nonetheless an area that is ripe for study, analysis and discussion of the results.
From the perspective of a GP, other issues may have had a significant impact. For example, GPs are under pressure to reduce referral rates, cut prescribing costs, improve access, accept more work from secondary care, keep people out of hospital and hit a number of targets. Does all this pressurise GPs into cutting corners?
These pressures are being applied at a time when cost cutting looms over all of us. Furthermore, as reported in another recent univadis article, availability of GPs may need to be enhanced during out of hours. It was reported that the Royal College of Physicians is calling for "access to primary care to be improved so patients can see their GP out of hours, relieving pressure on A&E services" (click here).
Of course, GPs and their teams are expensive commodities and the public and our paymasters expect good value for their investment. However, I wonder if GPs are being stretched too far and if too much is being expected from us, particularly when there is no spare cash to go round to absorb the increasing workload.
I would love to see some high-quality research in this area. Nobody in their right mind wants a complaint to the GMC, so it is imperative that we understand why these cases are happening and how we can stem the tide. It is in the best interests for all of us.
Dr Harry Brown, editor-in-chief Univadis
By Dr Harry Brown