Resilience
Sustaining primary care in crisis
‘Resilience’ means the ‘ability to bounce back from adversity’, but what is resilience in the primary care context? Resilience in primary care has multiple layers: interventions at individual, team, locality, and whole-system level will be needed to build a sustainable primary care system for the future. This web page aims to gather information and evidence to support that change.
This page features:
– Research
– BJGP Open articles
– Debate & Analysis
– Editorials
– Life & Times
– Related links
Research
*Latest research* – Job stress among GPs: associations with practice organisation in 11 high-income countries
Christine Cohidon, Pascal Wild and Nicolas Senn
Influence of patient multimorbidity on GP burnout: a survey and register-based study in Danish general practice
Fischer Pedersen A et al.
Association of GP wellbeing and burnout with patient safety in UK primary care
Louise H Hall et al.
General practice in UK newspapers: an empirical analysis of over 400 articles
Eleanor Barry and Trish Greenhalgh
Professional resilience in GPs working in areas of socioeconomic deprivation
Eleanor Eley, Ben Jackson, Chris Burton and Elizabeth Walton
GPs’ views of health policy changes: a qualitative ‘netnography’ study of UK general practice online magazine commentary
Rebecca Elvey, Jennifer Voorhees, Simon Bailey, et al.
Barriers, facilitators, and survival strategies for GPs seeking treatment for distress: a qualitative study
Johanna Spiers, Marta Buszewicz, Carolyn A Chew-Graham, et al.
GPs’ perceptions of resilience training: a qualitative study
Anna Cheshire, John Hughes, George Lewith, et al.
GPs’ mental wellbeing and psychological resources: a cross-sectional survey
Marylou Anna Murray, Chris Cardwell and Michael Donnelly
Influences on GP coping and resilience: a qualitative study in primary care
Anna Cheshire, Damien Ridge, John Hughes, et al.
GP views on strategies to cope with increasing workload: a qualitative interview study
Rebecca FR Fisher, Caroline HD Croxson, Helen F Ashdown, et al.
GPs’ perceptions of workload in England: a qualitative interview study
Caroline HD Croxson, Helen F Ashdown, FD Richard Hobbs
Resilience of primary healthcare professionals: a systematic review
Helen D Robertson, Alison M Elliott, Christopher Burton, et al.
Resilience of primary healthcare professionals working in challenging environments: a focus group study (see Letter response below)
Catriona Matheson, Helen D Robertson, Alison M Elliott, et al.
From BJGP Open
BJGP Open is the BJGP's open access international journal of primary care
*Latest research* – Burnout, resilience, and perception of mindfulness programmes among GP trainees: a mixed-methods study
Petra Hanson, et al.
Assessing the mental wellbeing of next generation general practitioners: a cross-sectional survey
Fanny Lindemann, et al.
Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians
Herman van Wietmarschen, Bram Tjaden, Marja van Vliet, et al.
Debate & Analysis
*Latest analysis* – Exploring ‘work–life balance’ at appraisal and how this links with organisational support
Jeremy Ferguson, Samantha Scallan, Johnny Lyons-Maris and Kerry Ball
Memory matters: how recall can build resilience
Alastair Dobbin and Sheila Ross
Compassion and the science of kindness: Harvard Davis Lecture 2015
Nigel Mathers
Bowlby, Balint, and the doctor–patient relationship: towards a theory of human relationships in medical practice
Jeremy Holmes and Andrew Elder
Resilience: what is it, why do we need it, and can it help us?
Mark Lown, George Lewith, Chantal Simon, David Peters
The three layers of resilience
Editorials
Physical activity in practice: why and how to get GPs moving
Ian Brockhurst, Jean Wong, Helen Garr and Mark E Batt
Stressed GPs: a call for action
Sanju George and Clare Gerada
The resilient general practice: working as a pack
Nick Bradley
Lifting the dead hand on general practice
John Sanfey and Sanjiv Ahluwalia
Enhancing compassion in general practice: it’s not all about the doctor
Antonio T Fernando III, Bruce Arroll and Nathan S Consedine
Who cares for the clinicians? The mental health crisis in the GP workforce
Johanna Spiers, Marta Buszewicz, Carolyn Chew-Graham, et al.
Damaged doctors: it’s time for a binding covenant of care between the NHS and its doctors
Dominic Patterson
Life & Times
*Latest Life & Times* – Looking after you too
Katie Barnett
Jumping in at the Deep End: supporting young GPs working in deprivation
Rachel Steen, Elizabeth Walton and Dominic Patterson
Breaking & Mending: A Junior Doctor’s Stories of Compassion & Burnout: Care for the Carers
Fiona Baskett
Books: The Art of General Practice: Soft Skills to Survive and Thrive: Social Skills and Fruitful Consultations
Gervase Vernon
Yonder: Burnout leave, asthma, Option Grids, and medicolegal risks
Ahmed Rashid
Mindful maps: a reading group for GPs and psychiatrists
Jane H Roberts
If You Want Good Personal Healthcare — See a Vet. Industrialised Humanity: Why and How We Should Care for One Another?
William House
Now is the time to work on your bucket list
Richard Armitage
Viewpoint: Resilience training, really?
Sarah Evans
My experience of being a doctor with psychosis
Katharine Fox
Books: Attending: Medicine, Mindfulness, and Humanity
Christopher Dowrick
Are you OK?
Tim Senior
Transforming the lives and careers of senior doctors: retaining and harnessing skills and enthusiasm in difficult times
Naureen Bhatti and Rebecca Viney
Bad Medicine: Resilience (see Letter responses below)
Des Spence
Ten Commandments for the resilient practitioner
Simon Tobin, Neal Maskrey
GPs’ demoralisation is due to our loss of human connection
David Zigmond
Increasing emotional support for healthcare workers can rebalance clinical detachment and empathy
Luke Austen
Sustainable general practice: looking across Europe
Mary McCarthy
Related links
*Latest resource* – NHS in Mind
Easy-to-access, short interventions and exercises to help colleagues through an incredibly difficult time
GP Wellbeing: Combatting Burnout in General Practice
This book is the first to explore the impact of burnout on GPs in the NHS and beyond
GP Health Service
Confidential NHS service for GPs and GP trainees
GP Survival
Facebook group
DocHealth
Psychotherapeutic consultation service for all doctors
The Vital Signs – A guide for doctors seeking help and advice [PDF]
Royal Medical Benevolent Fund
Tea and Empathy
Facebook group
GP resilience
Londonwide LMCs resilience page
Research for GPs
Twitter page @GPWellbeing
More than half of practice staff suffer physical illness from work stress
Caroline Price, Pulse
Is Resilience Enough?
InnovAiT Blog
When the doctor is sick too
The Lancet
Editorial from the InnovAiT Special Issue on Resilience
Toby Holland, InnovAiT
Top tips: Improving your resilience at work
Chris Johnstone, InnovAiT
If you know of related links to be considered for this page, please email them to journal@rcgp.org.uk
Recent features
Continuity of care is linked to mortality
A systematic review links reduced mortality rates to continuity of care, and examines causative mechanisms. Authors found a statistically significant protective effect of greater care continuity in 9 of 12 studies that measured the effect of all-cause mortality. Improved clinical responsibility, physician knowledge, and patient trust were suggested as causative mechanisms. This review adds reduced mortality to the demonstrated benefits of better continuity. Also online first in the BJGP is research on what patients with ongoing problems want from relational continuity of care.
Molecular point-of-care testing for flu:
integration into primary care
In managing influenza, antiviral treatment should ideally be started within 48 hours of the onset of symptoms. This study explores the use of rapid molecular testing in general practice to reduce diagnostic delay. Conventional testing procedures take considerably longer. Providing an earlier test result will help inform clinical decisions and may improve patient outcomes. Read the new research by de Lusignan and colleagues.
National early warning scores
Early warning scores alert clinicians to deterioration in a patient’s condition, with higher scores indicating poorer health. Originally developed for use in hospitals, new research extends the use of National Early Warning Scores (NEWS) to GPs. Scott and colleagues found that higher scores are associated with faster travel to hospital by ambulance, and with faster medical review after arriving at hospital. Related research by Pullyblank and colleagues examines the use of NEWS scores across a number of settings both in acute trusts and the community.