Mounting workload makes GP wellbeing guidance difficult to follow
British Medical Association union has urged family doctors to rotate workers between high and low stress activities and be alert to signs that colleagues might be in need of help
By Nadeem BadshahJul 13, 2023
NEW guidance encouraging GPs to focus on the wellbeing of themselves and their staff will be difficult to follow due to mounting workloads and more needs to be done, according to experts.
The British Medical Association union has urged family doctors to rotate workers between high and low stress activities, be alert to signs that colleagues might be in need of help and ensuring that senior staff are visible and available to talk.
It also advised GPs to arrange support groups and safe spaces for staff to speak openly, make them aware of the support available and encourage them to take breaks.
Dr Ajay Gupta, from the centre for clinical pharmacology and precision medicine at Queen Mary University of London, told Eastern Eye: “The BMA’s guidance – including increased visibility of the senior staff, provision of support and safe spaces to staff and ensuring a system of peer support – are all good practices that have been shown to improve emotional well-being and reduce burn-out among healthcare professionals.
“However, whether GPs have the time, resources or training to implement these changes is another catch-22 situation. “More out-of-box thinking is required to change the system, instead of recycling this advice and trying to optimise a system when the latter is working beyond its capacity in the first place.”
With GPs under pressure, the government in May announced that pharmacists will be able to give out prescription medicines and oral contraception to patients without GPs’ sign-off.
Treatments for seven common conditions – including earache, sore throat and urinary tract infections – are expected to be available in chemists without seeing a doctor from this winter.
Prime minister Rishi Sunak said he hoped the measures will help end the “alltoo stressful wait” for appointments by freeing up 15 million slots at doctors’ surgeries over the next two years.
Dr Chris Papadopoulos, principal lecturer in public health at the University of Bedfordshire, told Eastern Eye: “The publication of this guidance is a positive step towards acknowledging and attempting to support GP mental health which we know from the research evidence is poor.
“This isn’t surprising given the increasing levels of burnout and poor morale currently present in the workforce.
“However, the reality is that issuing guidance on how GPs can support their mental health simply is not enough.
“Most GPs will already have knowledge of such measures, but won’t have had the time or energy to act upon them.
“What GPs really need is better work-life balance, compassionate and safe workplace environments and access to supportive services and professional support - this costs money, but will likely be more effective than issuing them more guidance that GPs may perceive as more demands on them.”
Dr Judith Johnson is an associate professor in psychology at the University of Leeds and an expert in psychological resilience. She said: “Most of the suggestions don’t actually require more time, but they do require careful consideration.
“For example – encouraging a kind workplace, where colleagues look out for each other, requires a whole organisational shift.
“Management needs to be invested and to model this behaviour for their employees, as well as then creating opportunities for this to occur; for example, through coffee breaks and rewarding it.
“Rewards can be ‘soft’ such as verbal praise or ‘hard’, for example, by building it into appraisals. So, while this is just a bullet point on a list, the reality of implementation is quite different.”
Research in May found that 54 per cent of doctors admitted the impact of staff shortages on patient safety is affecting their own mental health.
A survey by Medical Protection, which represents more than 300,000 healthcare professionals around the world, found that two in five medics feared being sued or investigated due to incidents arising from staff shortages and that had a detrimental impact on their wellbeing.
Among those surveyed, 49 per cent acknowledged they are considering their career in medicine due to the impact of staff shortages on patient safety.
Medical Protection president, Professor Dame Jane Dacre, said: “The fact that most doctors feel the under resourced environments they work in presents a significant threat to patient safety, is a sad reflection of the times and is distressing for patients and doctors alike.
“The effect of not being able to provide excellent or even adequate care on a doc[1]tor’s mental wellbeing cannot be overstated. Nearly half the doctors we surveyed said they are considering their career in medicine because of this.
“The workforce is exhausted, fearful and many need support with mental health issues. When doctors’ mental wellbeing is poor, it is not only damaging for them, but also jeopardises patient care.”
The UK government recently announced that it had met its manifesto pledge of recruiting 26,000 additional primary care professionals such as dieticians, paramedics and physiotherapists to support doctors and nurses.
There are now 29,103 additional primary care staff and since March 2019, there are three and a half times more people working in these roles in GP practices.
INDIA is committed to efforts to develop Jammu and Kashmir, prime minister Narendra Modi said last Friday (6), accusing Pakistan of seeking to destroy livelihoods there with April's deadly attack on tourists.
He was speaking on his first visit to the Himalayan region since Islamist attackers targeted Hindu tourists in the popular Pahalgam area, killing 26 men, triggering hostilities between the countries that ended in a ceasefire last month.
"The atmosphere of development that emerged in Jammu and Kashmir will not be hindered by the attack ... I will not let development stop here," Modi said in remarks after inaugurating infrastructure projects.
Key among these was a $5-billion rail link between the Kashmir Valley and the rest of India, which has been more than 40 years in the making and features the world's highest railway arch bridge.
Others include highways, city roads and a new medical college.
"Pakistan will never forget... its shameful loss," the prime minister told crowds.
"Friends, today's event is a grand festival of India's unity and firm resolve," Modi said after striding across the soaring bridge to formally launch it for rail traffic.
"This is a symbol and celebration of rising India," he said of the Chenab Bridge, which connects two mountains.
New Delhi calls the Chenab span the "world's highest railway arch bridge", sitting 359 metres (1,117 feet) above a river.
While several road and pipeline bridges are higher, Guinness World Records confirmed that Chenab trumps the previous highest railway bridge, the Najiehe in China.
Modi said the railway was "an extraordinary feat of architecture" that "will improve connectivity" by providing the first rail link from the Indian plains up to mountainous Kashmir.
With 36 tunnels and 943 bridges, the new railway runs for 272 km (169 miles) and connects Udhampur, Srinagar and Baramulla.
It is expected to halve the travel time between the town of Katra in the Hindu-majority Jammu region and Srinagar, the main city in Kashmir, to around three hours.
The new route will facilitate the movement of people and goods, as well as troops, that was previously possible only via treacherous mountain roads and by air.
Trains run in the Kashmir valley, but the new link is its first to the wider Indian railway network. Apart from boosting the regional economy, it is expected to help revive tourism, which plummeted after the April attack.
Pakistan's foreign ministry, in a statement, said India's "claims of development... ring hollow against the backdrop of an unprecedented military presence, suppression of fundamental freedoms, arbitrary arrests, and a concerted effort to alter the region's demography".
Around 150 people protested against the project on the outskirts of Muzaffarabad, the capital of Pakistani Kashmir.
"We want to tell India that building bridges and laying roads in the name of development will not make the people of Kashmir give up their demand for freedom," said Azir Ahmad Ghazali, who organised the rally attended by Kashmiris who fled unrest on the Indian side in the 1990s.
"In clear and unequivocal terms, we want to say to the Indian government that the people of Kashmir have never accepted India's forced rule."
More than 70 people were killed in missile, drone and artillery fire during last month's conflict.
Modi also announced further government financial support for families whose relatives were killed, or whose homes were damaged, during the brief conflict – mainly in shelling along the heavily militarised de facto border with Pakistan, known as the Line of Control.
"Their troubles are our troubles," Modi said.
Pakistan aimed to disrupt the livelihoods of the poor in Kashmir, who rely heavily on tourism, Modi said, adding that he would face down any obstacle to regional development.
Last month, Islamabad said a just and peaceful resolution of the Kashmir dispute was essential to ensure lasting peace in the region, known for its snow-topped mountains, scenic lakes, lush meadows, and tulip gardens.
The region drew more than three million visitors last year.
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Chief adviser to the government of Bangladesh Professor Muhammed Yunus speaks during a live interview at Chatham House on June 11, 2025 in London, United Kingdom. (Photo by Leon Neal/Getty Images)
BANGLADESH interim leader Muhammad Yunus said on Wednesday (11) that there was "no way" he wanted to continue in power after elections he has announced for April, the first since a mass uprising overthrew the government.
The South Asian nation of around 180 million people has been in political turmoil since a student-led revolt ousted then prime minister Sheikh Hasina in August 2024, ending her 15-year rule.
Speaking in London, Yunus, asked if he himself was seeking any political post, the 84-year-old Nobel Peace Prize winner said there was "no way", waving his hands in the air for emphasis.
"I think none of our cabinet members would like to do that, not only me", he said.
Yunus was answering questions after speaking at London's foreign policy thinktank Chatham House, the Royal Institute of International Affairs.
He also said he wanted to unveil a "big package" of proposals next month that he dubbed a "July Charter" -- one year on since the students launched the demonstrations that toppled Hasina.
"We want to say goodbye to the old Bangladesh and create a new Bangladesh", Yunus said.
The charter is being drafted by a government "consensus commission", talking to political parties to "find that which are the recommendations they will accept", he added.
Yunus has long said elections will be held before June 2026, but says the more time the interim administration had to enact reforms, the better.
But after political parties jostling for power repeatedly demanded he fix a timetable, he said earlier this month that elections would be held in April 2026.
"Our job is to make sure that the transition is managed well, and that people are happy when we hand over power to the elected government," he said.
"So we want to make sure that the election is right, that is a very critical factor for us. If the election is wrong, this thing will never be solved again".
Yunus is also expected to meet in London with Tarique Rahman, acting chairman of Bangladesh Nationalist Party, which is widely seen as likely to sweep the elections.
Rahman, 59, the son of former prime minister Khaleda Zia, has lived in London since 2008 after being sentenced in absentia under Hasina -- convictions since quashed.
He is widely expected to return to Dhaka to lead the party in polls.
(AFP)
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The proposed reorganisation could save £43m a year, say council leaders, but critics question the figure
RESIDENTS can now have their say on a plan which would see the number of local councils in Leicestershire drop from eight to two.
The proposal is one of three put forward for the political re-organisation of Leicestershire after the government told local leaders it wanted areas with two tiers of councils – such as the county – to reduce it to a single-tier set up.
That does not mean just one authority for Leicestershire, however, with the eight district and borough councils, along with Rutland County Council, believing residents would be better served if Leicestershire was split in two. They are proposing one new council for the north of Leicestershire and Rutland, and a second covering the south and the city to remain separate.
Their proposal is at odds with the options put forward by Leicester City Council and Leicestershire County Council, both of which believe one ‘doughnut’ authority, taking in all of the county but leaving Rutland and the city separate, is a better approach.
Leicester mayor Sir Peter Soulsby also believes that city borders should expand to take in parts of Leicestershire, something the remaining council leaders and many county residents all say they oppose.
Now, the district and borough councils are seeking residents’ opinions on their “North, City, South” proposal.
Under the plan, the areas currently served by Charnwood, North West Leicestershire and Melton district and borough councils, and Rutland County Council, would be served by one authority, called the “North Leicestershire and Rutland” council.
Those under the control of Blaby, Harborough, Hinckley and Bosworth, and Oadby and Wigston district and borough councils would be served by the second authority, called “South Leicestershire” council. District and borough leaders believe this would allow councils to stay “connected and accountable” to the communities they serve, while still simplifying services and saving money, as the government has demanded.
The leaders said this approach could save nearly £43 million a year. However, this figure was disputed by the previous leaders of the county council who put the figure closer to £17 million.
Speaking on behalf of the eight authorities, leader of Melton Borough Council Pip Allnatt said: “Councils in the area are facing the biggest change in over 50 years and it is vital our communities are involved in helping to shape the future of local government. We encourage people, businesses and organisations to take part in the survey and tell us their views on our plans.
“This is the second time we have asked for views, and earlier this year more than 4,600 people and organisations responded to our original survey to help inform our interim plan… we will continue to make strenuous efforts to gather views from our communities and partners. Please have your say.”
The survey asks residents whether they agree with the principle of replacing the two-tier system with a single council structure, if they agree with the North, City, South approach put forward by the districts and boroughs, and if they agree with the areas proposed to be joined together under that plan.
The survey can be found on the North City South website with residents able to respond until Sunday, July 20. An explainer of all of the proposed changes and their impact on residents is also available there.
(Local Democracy Reporting Service)
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Donald Trump and Narendra Modi shake hands as they attend a joint press conference at the White House on February 13, 2025.
INDIAN and US negotiators reported progress after four days of closed-door meetings in New Delhi on Tuesday, focusing on market access for industrial and some agricultural goods, tariff cuts and non-tariff barriers, according to Indian government sources.
"The negotiations held with the US side were productive and helped in making progress towards crafting a mutually beneficial and balanced agreement including through achievement of early wins," one of the sources said to Reuters.
The US delegation, led by senior officials from the Office of the US Trade Representative, met Indian trade ministry officials headed by chief negotiator Rajesh Agrawal.
Both sides also considered ways to expand bilateral digital trade through improved customs and trade-facilitation measures, the sources added, noting that “negotiations will continue” with an eye on a quick conclusion of the initial tranche.
Interim pact expected soon
president Donald Trump and prime minister Narendra Modi agreed in February to finalise a bilateral trade agreement by autumn 2025 and to more than double two-way trade to $500 billion by 2030. Officials now expect to seal an interim deal by the end of this month, before Trump’s 90-day pause on reciprocal tariffs expires, including a possible 26 per cent levy on Indian goods.
Commerce minister Piyush Goyal, who is in Switzerland for talks with European counterparts, said India is ready to settle “simpler issues” first. Subsequent rounds could handle more complex matters, with the goal of signing the first tranche by September or October, the officials said.
India turned down US requests for wider access to wheat, dairy and corn while offering lower tariffs on US almonds, pistachios and walnuts. New Delhi also asked Washington to remove its 10 per cent baseline tariff, a step the US side opposed, pointing out that Britain accepted the same duty in its recent deal. India further sought relief from a 50 per cent duty on steel exports.
A 26 per cent tariff on Indian rice, shrimp, textiles and footwear—about one-fifth of India’s merchandise exports—could dent shipments and weigh on foreign investment, the sources warned. India has pledged to increase purchases of American liquefied natural gas, crude oil, coal and defence equipment.
India’s exports to the US climbed 28 per cent to $37.7 billion in the first four months of 2025, while imports rose to $14.4 billion, widening India’s surplus, US data showed.
US voices backing on terrorism fight
Separately, the State Department said the US “reaffirmed its strong support” for India’s fight against terrorism during last week’s visit to Washington by an Indian all-party parliamentary delegation led by Congress MP Shashi Tharoor.
Deputy secretary of state Christopher Landau met the group as part of New Delhi’s outreach following Operation Sindoor, launched after the 22 April Pahalgam attack that killed 26 people.
State Department spokesperson Tammy Bruce told reporters that a Pakistani parliamentary team headed by Bilawal Bhutto Zardari also met officials, including under secretary for political affairs Allison Hooker. “So that meeting occurred,” Bruce said.
Hooker reiterated US support for the current “– as you might imagine, thank God – between India and Pakistan,” Bruce added, referring to the cessation of on-ground hostilities.
Asked about possible Pakistani assurances on action against militants, Bruce declined to share details. On whether Trump might “mediate” on Kashmir, she said: “Well, I – obviously, I can't speak to what's on the mind or the plans of the President. What I do know is that I think we all recognise that President Trump in each step that he takes, it's made to solve generational differences between countries, generational war."
“So, while I can't speak to his plans, the world knows his nature, and I can't speak to any details of what he might have in that regard… But it is an exciting time that if we can get to a point in that particular conflict..,” Bruce said, adding that it is a “very interesting time.”
India has maintained that Jammu and Kashmir and Ladakh are an “integral” part of the country and has rejected any outside mediation.
(With inputs from agencies)
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Jaishankar, who is currently in Europe a month after India launched Operation Sindoor, said Pakistan was training 'thousands' of terrorists 'in the open' and 'unleashing' them on India. (Photo: Getty Images)
INDIA's external affairs minister S Jaishankar has said India would strike deep into Pakistan if provoked by terrorist attacks, and warned of retribution against terrorist organisations and their leaders in response to incidents like the Pahalgam attack.
Speaking to Politico on Monday, Jaishankar, who is currently in Europe a month after India launched Operation Sindoor, said Pakistan was training “thousands” of terrorists “in the open” and “unleashing” them on India.
“We are not going to live with it. So our message to them is that if you continue to do the kind of barbaric acts which they did in April, then there is going to be retribution, and that retribution will be against the terrorist organisations and the terrorist leadership,” he said.
“We don't care where they are. If they are deep in Pakistan, we will go deep into Pakistan,” he added.
Tensions between India and Pakistan rose after the April 22 terror attack in Pahalgam that killed 26 people. India responded with precision strikes on terror infrastructure in Pakistan and Pakistan-occupied Kashmir on May 7.
The hostilities lasted four days and ended on May 10 following talks between the directors general of military operations.
Causes and consequences
Jaishankar said the root causes of the conflict remain.
“It (Pakistan) is a country very steeped in its use of terrorism as an instrument of state policy. That is the whole issue,” he told Politico.
Asked if the conditions that led to last month’s war-like situation still existed, he said, “If you call the commitment to terrorism a source of tension, absolutely, it is.”
On losses, he said relevant authorities would communicate details when ready.
Jaishankar said India’s fighter aircraft and missiles inflicted greater damage on the Pakistani Air Force than the other way around, and that this forced Pakistan to seek peace.
“As far I'm concerned, how effective the Rafale was or frankly, how effective other systems were — to me the proof of the pudding are the destroyed and disabled airfields on the Pakistani side,” he said.
“The fighting stopped on the 10th for one reason and one reason only, which was that on the 10th morning, we hit these eight Pakistani, the main eight Pakistani airfields and disabled them,” he added, noting that satellite images are available on Google showing damaged runways and hangars.
Jaishankar is on a week-long visit to Europe, during which he will meet leaders in the European Union, Belgium and France to strengthen bilateral ties and reiterate India’s zero-tolerance policy on terrorism.