As it happened – Experiences of the COVID-19 pandemic from within GP Practices

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By Emily Burn, Research Fellow and Professor Judith Smith, Professor of Health Policy and Management
Health Services Management Centre (HSMC), University of Birmingham

The COVID-19 pandemic led to sudden and profound shifts in the way that general practice services are delivered. In early 2020, with very little time to plan, general practices re-organised their services to ensure they could continue to offer core primary care whilst attempting to limit the spread of the virus and protect patients and staff. The speed of these changes to service delivery was unprecedented in UK general practice and there was a rapid and significant increase in the number of consultations taking place via telephone or video. 

Alongside Louise Locock from the University of Aberdeen, and Becks Fisher at the Health Foundation, we carried out a study exploring the professional and personal experiences of the general practice workforce as the first year of the COVID-19 pandemic evolved. Within our study, 17 participants holding a variety of roles from practice managers to GPs  reflected on their working day through written blogs, voice notes and telephone interviews.

Our analysis of these shared experiences of what it was like to work in general practice during the first year of the pandemic has revealed the acute organisational and personal pressure experienced by GPs, nurses and practice managers. Even before the pandemic, the UK general practice workforce was under a great deal of strain. These pressures on the workforce have continued, though most social distancing measures have been dropped and the rollout of the vaccination programme in the UK has reduced hospitalisation and deaths attributable to COVID-19. There are long-term and profound staff shortages as the number of full-time equivalent general practitioners has decreased, and demand for appointments continues to be high.

The future delivery of general practice depends fundamentally on having enough people in the primary care workforce. Focusing on different aspects of practitioners’ well-being will also help to encourage people to enter and remain part of the general practice workforce. In their reports recorded during the working day, participants frequently discussed general practice in terms of its strong roots in the community and the professional relationships they had with patients over many years were clearly very important.

On occasion, participants discussed how their relationship with patients felt under particular strain during the pandemic – something made worse by erroneous negative portrayals in some sections of the media of general practice as being ‘closed’, when in fact they were working harder than ever and offering telephone, online and in-person appointments and playing a major role in the COVID-19 vaccine programme.

During the initial stage of the pandemic, some participants discussed how they felt a sense of increased autonomy as practices developed their response to COVID-19 with great speed. This initial heightened autonomy appeared to reenergise some participants. Exploring whether (and how) a greater sense of control could be incorporated into training and regulatory frameworks for the longer term might offer one potential way to address the burnout and exhaustion in general practice.

Overall, our research found the need to build on the findings of previous studies and explore how the general practice workforce interprets and works with their professional identity, particularly given the continuing use of remote-first consulting as a core part of primary care. The findings from our study have now been published and highlight the exhaustion and complex mix of emotions experienced by GPs and their teams throughout the first year of the COVID-19 pandemic. We’d like to thank the participants and the Health Foundation for supporting the study.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of the University of Birmingham.

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