Unless we look after ourselves, how can we look after our patients?


General practice is the jewel in the crown of the NHS. The system had been underfunded for at least a decade before the start of the pandemic and the cogs only keep turning due to the good will of our GPs and staff going the extra mile for our patients. GPs have consistently been ranked as one of the most trusted professions in society because we place our patients at the heart of everything that we do.

So why then, is the political narrative and media portrayal of general practice so negative? Why do my hardworking GP colleagues feel vilified and witch-hunted by both regulators and the public? Never before has general practice given so much and felt so persecuted for its efforts.

General practice has rolled out the lion’s share of the COVID-19 vaccine programme at the same time as honouring its core contractual obligations. We are problem solvers. We think innovatively outside the box. We get things done. That’s why the buck always stops with the GP. However, I would urge caution as a willing horse carries a heavy load. That horse is now on its knees, after being whipped to within an inch of its life.

Intolerable, unsustainable and unsafe workload leads to burnout, depression, and poorer quality care. In years gone by, in the era where general practice was more binary and black and white, in comparison to today’s confusing quagmire, some GPs wore the number of daily patient contacts as a badge of honour, but there is no honour in the graveyards where these GPs ended up.

It’s in our nature as GPs to put our patients at the heart of everything that we do, often at the expense of our own wellbeing. Self-preservation can seem counterintuitive to the majority of us inherently selfless GPs, but unless we look after ourselves, how can we look after our patients?

As Chair of the Nottinghamshire LMC, we have provided support and guidance to our member practices in how to deal with such pressures. Our Practice Liaison officers and our Roving Practice Manager regularly advise general practice teams on how to practically identify and reduce issues on an operational and strategic level.

I was honoured to be part of a recent #TeamGP Perspectives podcast on GP wellbeing in which we reflected on our own experiences and used them to help explain how we have managed to turn negative experiences into positive ones. We also discussed how sharing our own lived experiences can not only be cathartic but also a source of inspiration to others who may be struggling.

As the pandemic restrictions wind to an end over the coming weeks, we need to take stock. Variants of COVID-19 are causing further spikes in infection rates, but thankfully these are not associated with the same hospitalisation and mortality rates we witnessed at the start of the pandemic. This is largely due to general practice’s efforts in rolling out the vaccine programme and protecting the population. In this world of VUCA (volatility, uncertainty, complexity, and ambiguity) in the coming months we will face winter pressures, possible booster provision roll-out and overspill from secondary care.

We need to hope for the best and prepare for the worst. If we fail to prepare, we need to prepare to fail. It has never been more important to look after ourselves and our colleagues, and band together as a profession. Stay strong and keep safe, my friends. 

About the writer

Dr Carter Singh, GP partner and Chair of Nottinghamshire LMC, Vale of Trent Faculty and National Council Member.