- Majority of GPs say medicine shortages are causing them ‘moral distress’
- The crisis risks GPs’ ability to practice safely
- One-in-three GPs say they are anxious about coming to work
- Almost one-in-five say they intend to quit due to the pressures
- MDDUS calls for a better, more compassionate way for pressurised doctors to seek help and speak out about mental health concerns
Three quarters of family doctors are experiencing debilitating moral distress because they cannot access medicines they know their patients need, a new survey has found.
The impact of the UK-wide medicine shortages on GPs is so bad, one third of GPs who suffer moral distress say it happens on a daily basis.
That number doubles when it comes to those who admit it affects them at least once a week.
The survey, conducted for the doctors’ defence organisation MDDUS, shows that almost nine-in-ten GPs believe the shortage of prescription medicine is severely hampering their ability to practice safely.
More than a third (36%) say that medicine shortages have worsened in 2024, with over four-in-five (83%) saying there was a lack of guidance on how to advise patients about the shortages, including timescales for when the medicine they need will become available.
GPs report the scarcest medicines are hormone replacement therapy including oestrogens, progestogens and testosterone (86%), diabetes medicines (GLP-1 RAs such as Ozempic) (80%), epilepsy medicines (42%) and cardiac medicines (30%).
The impact of the medicine shortages doctors face includes seeing their patients’ health deteriorating (45%), being faced with angry or aggressive patients when they can’t have the first-line drugs they need (74%) and feeling anxious about coming to work because of the knowledge some patients will be angry or upset with them (30%).
One GP said:
"It is very demoralising working as hard as we can but still being unable to meet patients’ needs due to constraints outside of our control.
"It makes workdays harder than necessary and mentally exhausting."
The survey also found that 94% of GPs had seen their workload increase due to the medicine shortages.
More than half (53%) said they were concerned about the risk of a complaint or claim against them or their practice.
As a consequence of the various problems and complications of medicine shortages, a small but significant minority (17%) of GPs reported the issue is making them consider leaving the medical profession.
One GP stated:
“It is very frustrating. I can see it only getting worse rather than better. It makes you just want to give up sometimes.”
Another GP said:
“It makes you second guess yourself frequently. Clinical decisions are now being influenced by this lack of medications which leads to increased sense of worry.”
While the availability of some medicines has been impacted post Brexit, other significant factors include global supply chain issues and problems created by bureaucratic processes in the NHS.
MDDUS is calling on governments across the UK to urgently investigate better, more compassionate ways for pressurised medics to seek wellbeing help and speak out about their mental health concerns.
Dr John Holden, chief medical officer at MDDUS, said:
“We hear regularly from doctors about the enormous pressures they face every day in the NHS, but the crisis around medicine shortages is making things even worse.
“It is not uncommon for doctors to contact us when they feel they’re at the very edge of their ability to cope with these pressures.
“Our survey shows these ongoing shortages are leading to a significant number of GPs questioning whether they want to continue in their role at a time when the NHS needs to retain as many doctors as possible to cope with demand.
“It is also disturbing to see how many GPs are suffering from professional and personal moral distress because they feel they’re failing their patients by being unable to access the medicine they know is necessary.
“Regardless of which party forms the government after the general election, the incoming health secretary must urgently prioritise NHS workforce issues – including practitioners’ own mental health and wellbeing – as they get to grips with their new job.”
ENDS
MDDUS is a medical defence organisation with 65,000 members ranging across the spectrum of medical and dental specialties. It commissioned the research agency, Survation, to investigate the experiences of GPs in the ongoing medicine shortages in the UK. It surveyed 397 GPs from across the United Kingdom who are members of MDDUS.
The survey found that:
- 74% of GPs experience moral distress at work due to the impact of medicine shortages
- Of this group, 30% suffer moral distress every day at work, and a further 37% suffer it several times a week
- 45% reported seeing patients’ health deteriorate due to medicine shortages
- 74% reported having to deal with anger or aggression from patients who could not get the first line medication they want
- 25% said they were anxious about coming to work and being unable to prescribe the medication patients need
- 30% said they were anxious about coming to work knowing some patients might be angry or aggression when they can’t be prescribed medication they need
- Further details from the survey are available from the MDDUS press office if required
Moral distress occurs when someone, in this case a GP, knows the ethically correct action to take but is constrained from taking it. During a crisis or disaster, the frequency and severity of moral distress increases. The impact on doctors’ health from moral distress and moral injury can be significant, being linked to severe mental health conditions such as depression and PTSD.
Case study
One doctor who responded to the MDDUS survey, said:
“We have to spend an inordinate amount of time trying to check the supply issues about particular drugs. Sometimes even though we look on the appropriate medicine shortage protocols, local supply issues seem to be a lot different.
“It is getting rather surreal that many common medications are out of stock. This causes a lot of anxiety for my patients who have to frequently go from pharmacy to pharmacy trying to find a medication that they really need.
“We have to print out hardcopy prescriptions for patients to have to do this which takes time. In the days gone by community pharmacy would suggest alternatives, nowadays, they just tell us that something is not in. And that we have to decide what the alternative is or what the options are.
“The additional steps are creating potential errors though, mercifully, there have been no near misses here at the practice yet, but it is only a matter of time.
“My reception staff are facing anger from patients because the patients believe that it is our fault that medications are not available. Community pharmacies happy for us to take the brunt of this. This is quite a toxic scenario that is developing and unfortunately is now becoming the normal.
“So, in the face of a tsunami of work from secondary care, the massive demands of the public, this is yet another dimension to the inexorable increase in workload and stress for GPs.”
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