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ss triple helix - summer 2023,  crisis in general practice

crisis in general practice

KEY POINTS
  • The crisis is complex, has been exacerbated by COVID-19, and is creating stress throughout the National Health Service (NHS).
  • Prayer, Bible study, and Christian fellowship are vital to our own self-care.
  • We also need to care for our colleagues and ensure our patients are not losing out.
Eugenia Lee looks at how we care for our patients, our colleagues, and ourselves in the midst of the current crisis in general practice.
As a GP, I have never worked so hard in my whole career. There are fewer of us now and workloads have increased significantly. Between 2015 and 2023 there has been a reduction of whole-time equivalent GPs of seven per cent, while registered patients increased by seven per cent to 62 million in the same time frame.[1]

Despite providing more services, frontline clinical staff often see patients with unmet needs, having to deal with long waiting times to access primary and secondary care. At my practice, we never stopped seeing patients throughout the Covid pandemic. As a result, most staff in my practice have contracted Covid at least twice with varying degrees of severity. We have collectively mourned for colleagues who lost their lives serving during the pandemic. We all remember the days when we stood outside our door on a Thursday evening, clapping for the NHS only three short years ago. However, the crisis now seems to be deeper and more toxic than ever.

The NHS crisis is putting immense pressure in every aspect of our healthcare system. The COVID-19 pandemic has added to the challenges. An increased demand for hospital beds leaves patients overflowing into corridors. Ten-hour or longer waits for ambulances are commonplace. Exhausted medical and nursing staff are exiting their professions in droves. The impacts of the crisis are multiple. Coroners have reported that the widespread delays across the care system are leading to deaths.[2]

This has prompted discussions about the role of the government, the responsibilities of healthcare professionals, and the impact on society. As Christians, how can we respond to this crisis?

pray

'Prayer is the Christian's greatest weapon' - attributed to Billy Graham.

As children of God, we believe in the power of prayer. We should pray for healing and comfort for those who are sick, for wisdom and guidance for healthcare professionals, and for strength and resilience for our communities. We should also pray for our government to make wise and just decisions to address the crisis. We seek out our saviour through prayer and trust in his sovereignty. Pray on your own, pray with your prayer partner, pray in your home group. There may be times when you are too tired and just don't have the words; ask for the intercession of the Holy Spirit. CMF can help you find a local group in your church, community, region, workplace, speciality, or online.

immerse in God's word

When we feel hurt or broken by the situation around us, when we feel that this perfect storm battering the NHS, it is important to remind ourselves of our Lord's Sovereignty. In Genesis 18:14, when God promised the medical miracle of a baby to the elderly Abraham and Sarah, he says, 'Is anything too hard for the Lord?'[3]

Immerse yourself the word of the living God. It will bring strength and power to your challenging situation. CMF has resources you can use, including the online daily devotional Bible reflections on the CMF website,[4] or the Human Journey course,[5] which brings a biblical understanding about health in eight topics for church or home group.

love and support each other

We are called to love our neighbours as ourselves.[6] This means that we should be concerned about the health and wellbeing of those around us, especially those who are vulnerable and in need, but also our colleagues. As a GP appraiser, trainer, and Programme Director for my local GP training scheme, I have often met colleagues who are burning out or burnt out.

We should pray for the NHS workers who are on the front lines of this crisis, putting themselves at risk to care for others. We should also support them in practical ways, such as mentoring, peer-group networks, donating food or supplies, sending cards or messages of encouragement, or volunteering our time if possible. It is important to look after our colleagues, bearing each other's burdens,[7] whether they are junior or senior to us. Other forms of support include counselling, workplace adaptation, seeking treatment, or providing time off work.[8]

And we should also be aware of when we are struggling ourselves and seek ways to survive and thrive in our situation. This may be through our church, our local CMF group, or our hospital chaplains.

sanctity of human life

As Christian doctors, we recognise that human life is precious and valuable. Every person is made in the image of God and has inherent worth and dignity.[9] This means that we should prioritise the health and safety of individuals over economic or political considerations. With the cost of living rising, we should advocate for policies that protect the most vulnerable members of society, including the elderly, disabled, and those with underlying health conditions. We should also speak out against any forms of discrimination or prejudice that may be exacerbating the crisis. In our daily encounter with patients, compassion has been shown to be foundation of successful care. Research on chronic pain has shown that the outcome for patients with a strong, empathic relationship with their care provider are improved.[10]

agents of reconciliation

As Christian doctors in different settings, we are called to be peacemakers and agents of reconciliation.[11] We should seek to promote unity and cooperation, rather than division and conflict. We should support initiatives that bring people together, such as community outreach programs or charitable organisations. We should also be willing to listen to and learn from others, even those who may have different perspectives or opinions. Those of us in senior positions can use our power to bring these Christian values into the workplace through policy change, workflow management, and being a good role model.

accountability

As Christians, we believe in the importance of stewardship and accountability. We should hold our government and healthcare providers accountable for their actions and decisions, ensuring that they are acting in the best interests of the public. Practical ways of taking up leadership roles within our local health system, include sitting on the Local Care Boards, Integrated Care Systems, and NICE committees. These roles in my career have given me opportunities to act as salt and light in the system.

hope

Finally, as Christians, we have hope in the midst of crisis. We believe that God is sovereign and that he is in control, even when things seem chaotic or uncertain. We can trust that he is working all things together for the good of those who love him,[12] and that he will ultimately bring about justice and healing. We can find comfort and peace in his presence, knowing that he is with us in every circumstance.

The NHS crisis is indeed complex and multifaceted issue that requires a holistic and compassionate response from each of us. Through our actions as individuals, there are many ways we can bring about a more positive work environment, a stronger and healthier team, and improve the outcome for our patients. May we all work together to overcome this crisis.

Eugenia Lee is a GP in Southeast London with a portfolio career in management, education, and policy.

References
  1. Pressures in general practice data analysis. BMA. 2023. bit.ly/3MG0g4J
  2. Dyer C. Coroners warn ministers that delays in attending to patients are leading to deaths. BMJ. 2023; 380:243. doi:10.1136/bmj.p243
  3. Eg Proverbs 30:5 and Deuteronomy 31:8
  4. See the online 'Doctor's Life Support' daily devotionals at cmf.li/Devotional
  5. humanjourney.org.uk
  6. Mark 12:31
  7. Galatians 6:2
  8. Shemtob L. et al. Supporting healthcare workers with work related stress. BMJ. 2022; 379 :e070779 doi:10.1136/bmj-2022-070779
  9. Genesis 1:27
  10. Stannard C, Wilkinson C. Rethinking use of medicines for chronic pain. BMJ. 2023; 380 :p170 doi:10.1136/bmj.p170
  11. Matthew 5:9
  12. Romans 8:28
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