Amandip Sidhu’s charity has helped more than 3,000 people since it was set up, offering, among other things, weekly drop-in Zoom support groups. ‘We hear time and time again that more and more GPs are working longer hours. They don’t just see patients, there is a huge amount of administration and bureaucracy,’ he says. ‘There are more patients than there were before, with more complex needs. As the health needs have evolved the level of resources has not.’ Partners also have the additional burden of running a business.
Precise figures on GP suicides are difficult to pin down because the Office for National Statistics groups doctors together when compiling its figures, but a 2022 survey found that one in four GPs knew of a general practice colleague who had taken their own life, while 84 per cent reported experiencing anxiety, stress or depression associated with their job in the previous year.
In the year to March 2023, Practitioner Health saw 6,741 people – 40 per cent of whom were GPs, even though GPs make up less than 34 per cent of NHS practitioners.
Lucy Warner, the chief executive of Practitioner Health, says that not only have numbers increased, but people seeking help are more mentally ill when they enter the service. ‘There is an awful lot of “last person standing” going on in GP surgeries,’ she says.
The problem is not unique to Britain. In the US, doctors have one of the highest suicide rates of any profession, and Professor Gerada says that there is an increasing problem with GP mental health in almost every country that produces statistics.
Juliette Stern, whose husband Miles Christie, a London-based GP, died by suicide in 2018, believes the NHS should force surgeries to hold weekly gatherings where all GPs can discuss and share their concerns, monitor each others’ well-being and talk over patient diagnoses they might be unsure about.
In the case of her husband, who was 42 when he died, she says isolation was a major factor, as GPs work in silos, making dozens of decisions each day without the time to chew things over with colleagues.
‘He was working endless hours and was subsidising his income with private work,’ she says. ‘He also had an annual appraisal coming up when you are supposed to declare any medical issues but he was worried he wouldn’t be able to practise if he said he was suffering from stress and anxiety.
‘He wasn’t sleeping, he started self-medicating with valium and he ended up going to A&E with his father, a retired paediatrician, because we were very worried about him. [But] he saw a junior doctor and managed to say all the right things that made it seem like he wasn’t in a suicidal state.’
The family made a private appointment for him to see a psychiatrist two days later, but instead of attending the appointment he took his own life. He left behind two children, then aged two and four.
His widow puts this squarely down to a job he was crushed by. ‘You are listening to people’s problems and concerns in 10-minute slots and worrying that you’re making the right clinical decisions for them and there’s just no place to discuss that with anyone.’
It didn’t have to be like this, she adds, ‘[he was] incredibly charismatic and handsome… He could have gone on to be another Dr Hilary Jones [on television].’
The Government will point to the fact that the number of GPs has recently risen slightly: there were 37,177 individual fully qualified GPs in England in January this year, up by 689 from January 2023, though the full-time-equivalent number was 27,534 (up by 248).
At the 2019 election, the Conservative Party promised to recruit an extra 6,000 GPs by 2024/25, but the actual increase in full-time-equivalent doctors, including trainees and locums, has been 2,716. The number of fully qualified, full-time-equivalent GPs, meanwhile, is almost 1,800 lower today than it was a decade ago.
Lizzie Toberty, a GP based in Newcastle upon Tyne and the GP lead at the professional body Doctors’ Association UK, says workloads can be managed with better triaging. Her surgery uses a web-based system called Ask My GP and encourages patients to email their requests for appointments, phone consultations or letters, which are then read by an on-call GP who prioritises them and decides what sort of appointment is needed.
‘There are other triage systems that require patients to fill in lengthy questionnaires but ours is simpler and we aim to deal with everything within 24 hours,’ Toberty says. People without access to email phone reception.
‘If you just open your appointments book, people will make an appointment [just to] ask us to write a letter to support them cancelling their gym membership on health grounds, when we could just deal with that via email. If they can email you to say what they need, it saves a lot of time. And if someone needs blood tests, we can send them for a blood test before they come to surgery rather than seeing them, arranging a test and seeing them again.’
When doctors are writing emails or speaking to patients on the phone, they do so from a central hub at her surgery, next to the on-call doctor, meaning three or four of them at a time can speak to each other, offer support and discuss cases if necessary. They also have weekly meetings – Juliette Stern would like these to be made mandatory.
‘I am in control of my day,’ Toberty says. ‘I do get stressed because you are holding so much risk and responsibility, but because I work with great people and I know I’m supported I still enjoy it. It’s a great job.’
Why Can’t I See My GP?: The Past, Present and Future of General Practice, by Dr Ellen Welch, is out now (Calon, £16.99); order here