The feature explores how medics are disproportionately likely to die by suicide and highlights the immense strain family doctors are working under.

Dr Sarah Jacques shares her personal story, which she hopes will amplify the growing issue of adverse mental health in the NHS workforce.

She said: “‘Medicine is a vocation. You don’t stop being a doctor, it’s so much a part of you and when you don’t feel you’re doing it well you feel worthless.”

Our former co-chair, Dr Ellen Welch, author of Why Can’t I See My GP?, talks about the reasons behind plummeting morale among GPs.

“People have gone overseas, for example to Australia, where the salary can be almost triple what it is here and doctors have more time with their patients,” said Dr Welch.

Dr Lizzie Toberty, our GP lead, discusses how workloads can be managed with better triaging.

She concluded: “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.”

Read the feature on GPs in crisis.

Sign up to be a DAUK member and support our work.

A survey of doctors by the General Medical Council asked how likely they were to move abroad to practise medicine in the next 12 months.

More than 13 per cent of those practising in the UK answered ‘very likely’. A further 17 per cent said they were ‘fairly likely’.

Speaking on Times Radio, Dr Toberty said: “I’m not surprised by the figures and I don’t think anyone working in the NHS will be surprised to hear them.

“We heard a couple of weeks ago that patient satisfaction was at an all-time low and this is representing staff satisfaction, and staff satisfaction I would say is at an all-time low.

“The question we need to ask ourselves is if I was sick, or a member of my close family is sick and unwell, am I happy for them to wait 10 hours in A&E, or three months for cancer treatment, or six weeks for a GP appointment?

“If the answer is no, I’d like there to be a doctor available, clear-thinking and ready to treat me should I need it then I think we have to take these figures really seriously.”

Dr Toberty said the high training standards meant that UK doctors were being targeted by other countries.

“In this country we have really excellent training for undergraduate and postgraduate,” she said.

International market

“Our doctors have an excellent knowledge base and communication skills.

“The rest of the world knows this and wants us.

“We need to recognise this is an international market. Places like Australia, New Zealand, Canada, the Middle East, the Republic of Ireland realise this and are very much pushing it.

“It’s not just people moving abroad, it’s people retiring early, it’s people moving into other sectors, it’s people saying I’ve had enough.

“We all know morale is low but very little is being done to tackle that.”

Dr Toberty said one way of improving morale was for employers to produce a plan for the future travel of the NHS.

“I think it’s about hope,” she said. “We have had years of austerity and the overall message to the workforce in the NHS is things aren’t going to get much better.

“I understand we can’t turn the situation around overnight, but we can provide a plan and that hope that there are going be good careers coming here and there are going to be ways of maintaining a work-life balance.

“Part of that, of course, is about remuneration and about pay, but it’s about so much more in terms of working conditions.

“It’s about the way we train people, moving them around the country, moving people away from their partners, their children.

“Giving people parking tickets when they park in the wrong place on call.

“These are small things that chip away at people’s psychological wellbeing and make people feel undervalued.”

Student loan forgiveness

Dr Toberty added that debt forgiveness, which could see some or all of NHS workers’ student fees written, might also be a way to improve morale.

“We’ve got young people aged 23, 24, graduating with more than £100,000 worth of debt,” she said.

“Even when they start paying off their student loan, the interest on the debt is rising.

“It’s really depressing to look at your debt and think you’ve got no chance of paying it off and paying it down.

“Giving people realistic prospects of paying off their student loans would be a good way forward.”

Read the GMC survey in full.

Grassroots lobbying group Doctors’ Association UK (DAUK) argues the current system is unsustainable and does not give GPs enough flexibility on how and where they spend allocated budgets.

It said their hands are tied, as their funding is directed by NHS England though primary care networks (PCNs) – GP practices working together with community, mental health, social care, pharmacy, hospital and voluntary services in their local area – with strict budget criteria.

The association is concerned that GP practices are not able to spend the money on extra doctors where they are needed. Its warning comes as a report published this week warned that up to half of GP posts could be vacant by the end of the decade.

Dr Lizzie Toberty, GP lead at DAUK, said: “Money that comes down from NHS England via the PCNs is very tightly controlled. It is not for GPs, nurses or new buildings, but only for other allied healthcare professionals. We’re told how much we can spend on a social prescriber or a pharmacist, but that might not be what your area needs.

“Areas within a one mile radius, never mind the whole of England, can have extremely different health population needs. Trying to stipulate from NHSE head office which type of staff can be employed in rural Lincolnshire or inner city Sunderland is ridiculous, yet it is what is happening. It’s extremely problematic.

“I’m concerned that non-doctor staff may not be able to perform GP roles to the same level of quality and effectiveness. Yes physician associates can have their role, and they are welcome additions to our over stretched teams, but as our patients are becoming more complex, you need doctors with breadth of training and experience in order to manage multiple conditions simultaneously.”

read the full article here

Dear Independent Press Standards Organisation,

We would like to raise a formal complaint following a recent article published in the Mail Online by Mr Connor Boyd, Deputy Health Editor.

On 8 June 2022, Mr Boyd wrote an article entitled, “Fury at video that lays bare huge A&E waits ‘being fueled by GPs’”.
 (https://www.dailymail.co.uk/health/article-10896287/The-shocking-video-lays-bare-dire-state-NHS.html)

The opening paragraph of Mr Boyd’s article states:

“A dire lack of access to GPs has been blamed for the country’s A&E crisis after video emerged of patients being told they faced waits of up to 13 hours in an emergency department.”


In reference to the Editors’ Code of Practice, we wish to report breaches of the following sections of Clause 1 (Accuracy):

i) The Press must take care not to publish inaccurate, misleading or distorted information or images, including headlines not supported by the text.

iv) The Press, while free to editorialise and campaign, must distinguish clearly between comment, conjecture and fact.

There is no evidence whatsoever to demonstrate that long A&E waits result from, or are fuelled by GPs.

This headline is clearly inaccurate, misleading and not supported by text. Whilst quotations marks are used in the headline, these specific words are not attributed to anyone (anonymous or otherwise) in the article.

Our most recent appointment data from NHS Digital shows that 25.3 million GP appointments were held in April 2022, up from 16.6 million GP appointments in April 2020.

Appointments in General Practice, April 2022 – NHS Digital: https://digital.nhs.uk/data-and-information/publications/statistical/appointments-in-general-practice/april-2022

During this same time, there were 2,028,228 A&E attendances in April 2022 compared to 916,575 attendances in April 2020.

Statistics » A&E Attendances and Emergency Admissions 2022-23: https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/ae-attendances-and-emergency-admissions-2022-23/

It is therefore clear that all frontline health services are stretched at this time, yet Mr Boyd unreasonably and inaccurately chooses to blame GPs for delays within hospital settings and also bed shortages.

Throughout his article, Mr Boyd makes no attempt to distinguish between comment, conjecture and fact.

It is evident that this is not an opinion piece, and it appears that no GPs were interviewed and no professional medical bodies were approached for comment.

We respectfully seek your support to help correct this false narrative and restore the integrity of our GPs that continue to work above and beyond the call of duty.

Dr Ellen Welch, GP, Co-Chair DAUK
Dr Matt Kneale, Foundation doctor in A&E Co-Chair DAUK
Dr Elizabeth Toberty, GP Lead DAUK

Response from IPSO

DAUK will be appealing the above decision by IPSO. Our appeal:

Pulse have followed this story closely and you can read their coverage here

Read the Latest Response by IPSO on our appeal: 

Dear Dr Welch,

The Complaints Committee has considered your complaint, the email from IPSO’s Executive notifying you of its view that your complaint did not raise a possible breach of the Code, and your email requesting a review of the Executive’s decision. The Committee agreed the following decision: The Committee appreciated that this article was a source of frustration for you and that you considered it to be exacerbating low morale among GPs. However, while the Committee was sorry to hear of these concerns, IPSO can only address concerns linked to the Editors’ Code of Practice. You provided data which you considered demonstrated that the selection of data in the article was misleading. However, the Committee wished to highlight that newspapers are entitled to publish what they choose, provided the information is accurate. Where you did not dispute that the figures themselves selected for publication were accurate, there was no reason to investigate a possible breach of Clause 1 on this point. You expressed concerns that the article’s headline was based on opinions of people quoted in the article, rather than facts. The Committee firstly noted that the were no specific findings of inaccuracies in the article. Additionally, the Editors’ Code does not require that the headlines of news articles are not based on the opinions of individuals; the requirement is that headlines are supported by the text of the article. Where – as you pointed out – the headline is supported by opinions quoted in the article, there was no possible breach of the Code on this point. For this reason, and the reasons already provided by IPSO’s Executive, the Committee decided that your complaint did not raise a possible breach of the Code. As such, it declined to re-open your complaint. The Committee would like to thank you for giving it the opportunity to consider your concerns.

Best wishes,

Molly Richards

Complaints Officer

DAUK’s GP Team were among the signatories to a letter published in The Observer this weekend, opposing the view that general practice’s problems could be overcome by hiring younger doctors. The letter reads:

Torsten Bell uses US data to claim that when GPs retire, the use of other emergency services rises (“Why baby boomers might end up healthier if their GPs retire early”, Comment). This in itself would be an argument to strengthen primary care in the UK. Bell then claims that new GPs are more likely to pick up a new diagnosis of diseases such as Alzheimer’s, concluding that GPs retiring can be a good thing for patients, while pointing out that it also pushes up the cost of healthcare.

We believe that GP continuity of care not only saves lives and money but also leads to longer life expectancy. The age of your GP is not the problem here. It is the absolute lack of them. The UK is facing a GP crisis that long predates the pandemic. We need to retain our GPs at all stages of their careers – but especially those with many years of experience – who are also best placed to support and mentor junior GPs and the ever-growing number of allied healthcare professionals who are being employed to try to prop up a failing system in the UK.

Contrary to widespread reports, GP surgeries have remained open throughout the Covid-19 pandemic. Official NHS data confirms that more GP appointments are being offered than ever before, and GP teams continue to provide over 90 percent of all NHS consultations. 

Practices were already struggling prior to the pandemic and are now facing near-impossible challenges in the face of a “tsunami of demand”.

Attendees at this briefing heard from frontline GPs who described:

• The causes of rising demand on our services
• The increasing cases of burnout amongst GPs
• The damaging effects of unproven bureaucratic interventions
• Consequences of the demoralising, harmful narratives against our profession
• Proposed solutions to our challenges
• How you can help us help our patients

“From a GP’s perspective, the waits now for hospital treatment, for elective care and for investigations are becoming unacceptable, and we’re having to support all our patients who are waiting for that treatment, who need that really to help them move on with their lives – and we’re trying to support them. It’s one of the big reasons we’re seeing such a rise in demand.”

“We are seeing huge staff shortages. The question really on my mind, and I think on the minds of a lot of NHS staff, is what’s the plan here?

“How are we going to staff these beds and make sure people get the care they need?”

nhs staff
She added: “My worry for my patients is what if they get something that is not Covid related but still needs urgent treatment and the staff that are needed to treat them are off with Covid?”

Dr Lizzie Toberty

read the full article here

Read the full article in Pulse

GPs have told Pulse of buying their own higher grade PPE to protect staff as the new Omicron Covid variant is sweeping over the country.

Current infection prevention and control (IPC) Government guidance recommends ‘face coverings or surgical masks (Type II or IIR) to prevent the transmission of SARS-CoV-2 and other respiratory infectious agents in health and care settings’.

Dr Lizzie Toberty, North East GP and Doctors Association GP lead, told Pulse: ‘Two years into the pandemic, we should definitely have better PPE…. And surely health and safety laws would say that there is a responsibility on the NHS to provide adequate steps to keep us safe. And I don’t think that that’s there at the moment.’

She said: ‘It shows a disdain for staff, that in the same week Boris Johnson sent out a letter thanking us, we’re not being provided with the basics to enable us to look after our own health and therefore look after our patients.’

She also said it should be done centrally ‘from a practical perspective’, as she struggled to know which FFP3 mask was the right one when looking for herself.