Tag Archives: levels

Glyphosate shown to disrupt microbiome ‘at safe levels’, study claims

A chemical found in the world’s most widely used weedkiller can have disrupting effects on sexual development, genes and beneficial gut bacteria at doses considered safe, according to a wide-ranging pilot study in rats.

Glyphosate is the core ingredient in Monsanto’s Roundup herbicide and levels found in the human bloodstream have spiked by more than a 1,000% in the last two decades.

The substance was recently relicensed for a shortened five-year lease by the EU. But scientists involved in the new glyphosate study say their results show that it poses “a significant public health concern”.

One of the report’s authors, Daniele Mandrioli, at the Ramazzini Institute in Bologna, Italy, said significant and potentially detrimental effects from glyphosate had been detected in the gut bacteria of rat pups born to mothers, who appeared to have been unaffected themselves.

“It shouldn’t be happening and it is quite remarkable that it is,” Mandrioli said. “Disruption of the microbiome has been associated with a number of negative health outcomes, such as obsesity, diabetes and immunological problems.”

Prof Philip J Landrigan, of New York’s Icahn School of Medicine, and also one of the research team, said: “These early warnings must be further investigated in a comprehensive long-term study.” He added that serious health effects from the chemical might manifest as long-term cancer risk: “That might affect a huge number of people, given the planet-wide use of the glyphosate-based herbicides.”

Controversy has raged around glyphosate since a World Health Organisation agency – the International Agency for Research on Cancer (IARC) – judged it to be a “probable human carcinogen” in 2015.

However, US and European regulators subsequently deemed it acceptable for use, a move campaigners condemned because of regulators’ use of secret industry papers and experts with alleged ties to Monsanto.

The US firm, which recently merged with Bayer in a deal worth more than $ 60bn, argues that it is being unfairly targeted by activist scientists with ulterior motives.

Scott Partridge, Monsanto’s VP for global strategy told the Guardian: “The Ramazzini Institute is an activist organisation with an agenda that they have not disclosed as part of their crowdfunding efforts. They wish to support a ban on glyphosate and they have a long history of rendering opinions not supported by regulatory testing agencies.”

“This is not about genuine research,” he added. “All the research to date has demonstrated that there is no link between glyphosate and cancer.”

In 2017, the Ramazinni Institute was criticised by members of the US Congress, which has provided it with funding. US congress members have also probed funding for the IARC.

The new crowdfunded pilot study which the Ramazzini Institute compiled with Bologna University and the Italian National Health Institute observed the health effects of glyphosate on Sprague Dawley rats, which had been dosed with the US EPA-determined safe limit of 1.75 micrograms per kilo of body weight.

Two-thirds of known carcinogens had been discovered using the Sprague Dawley rat species, Mandrioli said, although further investigation would be needed to establish long-term risks to human health.

The pilot research did not focus on cancer but it did find evidence of glyphosate bioaccumulation in rats– and changes to reproductive health.

“We saw an increase in ano-genital distance in the formulation that is of specific importance for reproductive health,” Mandrioli said. “It might indicate a disruption of the normal level of sexual hormones.”

The study’s three peer-reviewed papers will be published in Environmental Health later in May, ahead of a €5m follow-up study that will compare the safe level against multiple other doses.

Glyphosate shown to disrupt microbiome ‘at safe levels’, study claims

A chemical found in the world’s most widely used weedkiller can have disrupting effects on sexual development, genes and beneficial gut bacteria at doses considered safe, according to a wide-ranging pilot study in rats.

Glyphosate is the core ingredient in Monsanto’s Roundup herbicide and levels found in the human bloodstream have spiked by more than a 1,000% in the last two decades.

The substance was recently relicensed for a shortened five-year lease by the EU. But scientists involved in the new glyphosate study say their results show that it poses “a significant public health concern”.

One of the report’s authors, Daniele Mandrioli, at the Ramazzini Institute in Bologna, Italy, said significant and potentially detrimental effects from glyphosate had been detected in the gut bacteria of rat pups born to mothers, who appeared to have been unaffected themselves.

“It shouldn’t be happening and it is quite remarkable that it is,” Mandrioli said. “Disruption of the microbiome has been associated with a number of negative health outcomes, such as obsesity, diabetes and immunological problems.”

Prof Philip J Landrigan, of New York’s Icahn School of Medicine, and also one of the research team, said: “These early warnings must be further investigated in a comprehensive long-term study.” He added that serious health effects from the chemical might manifest as long-term cancer risk: “That might affect a huge number of people, given the planet-wide use of the glyphosate-based herbicides.”

Controversy has raged around glyphosate since a World Health Organisation agency – the International Agency for Research on Cancer (IARC) – judged it to be a “probable human carcinogen” in 2015.

However, US and European regulators subsequently deemed it acceptable for use, a move campaigners condemned because of regulators’ use of secret industry papers and experts with alleged ties to Monsanto.

The US firm, which recently merged with Bayer in a deal worth more than $ 60bn, argues that it is being unfairly targeted by activist scientists with ulterior motives.

Scott Partridge, Monsanto’s VP for global strategy told the Guardian: “The Ramazzini Institute is an activist organisation with an agenda that they have not disclosed as part of their crowdfunding efforts. They wish to support a ban on glyphosate and they have a long history of rendering opinions not supported by regulatory testing agencies.”

“This is not about genuine research,” he added. “All the research to date has demonstrated that there is no link between glyphosate and cancer.”

In 2017, the Ramazinni Institute was criticised by members of the US Congress, which has provided it with funding. US congress members have also probed funding for the IARC.

The new crowdfunded pilot study which the Ramazzini Institute compiled with Bologna University and the Italian National Health Institute observed the health effects of glyphosate on Sprague Dawley rats, which had been dosed with the US EPA-determined safe limit of 1.75 micrograms per kilo of body weight.

Two-thirds of known carcinogens had been discovered using the Sprague Dawley rat species, Mandrioli said, although further investigation would be needed to establish long-term risks to human health.

The pilot research did not focus on cancer but it did find evidence of glyphosate bioaccumulation in rats– and changes to reproductive health.

“We saw an increase in ano-genital distance in the formulation that is of specific importance for reproductive health,” Mandrioli said. “It might indicate a disruption of the normal level of sexual hormones.”

The study’s three peer-reviewed papers will be published in Environmental Health later in May, ahead of a €5m follow-up study that will compare the safe level against multiple other doses.

FDA pushes to lower nicotine to ‘minimally or non-addictive levels’

The US government is making a strong push to lower nicotine levels in cigarettes to “minimally or non-addictive levels”, the regulator Scott Gottlieb announced Thursday.

If the US Food and Drug Administration succeeds in mandating reduced nicotine, the agency said 33 million young people could be prevented from becoming regular smokers, and it would prompt 5 million people to quit within one year of implementation.

The latest push for changes will amend federal regulations, a process that does not involve Congress and has become a favorite tactic of the Trump administration to bring about change.

The rate of Americans who smoke has declined to 15% in the last decade. Nevertheless, tobacco-related illness still kills 480,000 Americans and costs the US $ 300bn per year, the FDA said.

Gottlieb, the commissioner of the FDA, said the announcement was “a significant step in our efforts to confront nicotine addiction in combustible cigarettes”. He added: “This milestone places us squarely on the road toward achieving one of the biggest public health victories in modern history and saving millions of lives in the process.”

The move is part of a comprehensive and ambitious government tobacco plan announced in July.

The plan emphasizes “harm reduction” – for example, encouraging people to switch to e-cigarettes as an alternative to traditional cigarettes.

The tobacco industry remains one of the most influential special interest groups in Washington DC, and a disproportionate backer of Republicans. Tobacco companies spent $ 21m lobbying Congress in 2017 alone, and also spent $ 5.1m on political campaigns in 2016.

Thursday’s FDA announcement begins a multi-year process and formally requests public input.

Altria Group, the company formerly known as Philip Morris and maker of Marlboro cigarettes, downplayed the significance of the announcement.

“Today’s advance notice is a request for information, not a proposed rule,” said Murray Garnick, general counsel for Altria Group. The announcement “is the first step in a multi-year process that will require the agency to examine and resolve many complex issues”.

In recent years, tobacco companies have lobbied against regulations on e-cigarettes and cigars. A recent FDA scientific review found e-cigarettes are less harmful than traditional smoked tobacco, but not wholly harmless.

Gottlieb has long been a proponent of e-cigarettes as a harm reduction tool. The commissioner held investments in an e-cigarette company when he was nominated for FDA chief.

Although the overall rate of Americans who smoke is declining, public health gains are not evenly spread. Smokers are disproportionately likely to be poor, less educated, and live in the south or midwest. For example, 40% of people who hold a high school diploma equivalent smoke.

Tobacco advertising restrictions have closed off companies’ ability to advertise at sports events or on television, but companies still spend $ 1m per hour advertising. Most advertising is for coupons to reduce the cost of cigarettes.

Matthew Myers, the president of the Campaign for Tobacco Free Kids, said the potential rule change represented a “once in a lifetime” opportunity to impact public health, and urged the FDA to set a deadline for changes.

“Given these enormous public health benefits and the millions of lives that would be saved, it is critical that the FDA move as quickly as possible to turn this plan into reality,” said Myers. “There is no other single action our country can take that would prevent more young people from smoking or save more lives.”

Myers also urged the FDA to push for other regulations now common in the western world, including graphic warning labels on cigarette packs and prohibiting flavored and menthol tobacco.

Huge levels of antibiotic use in US farming revealed

Concerns raised over weakened regulations on imports in potential post-Brexit trade deals

A farmer prepares to vaccinate a calf on a cattle ranch.


A farmer prepares to vaccinate a calf on a cattle ranch. Photograph: Jim West/Alamy

Livestock raised for food in the US are dosed with five times as much antibiotic medicine as farm animals in the UK, new data has shown, raising questions about rules on meat imports under post-Brexit trade deals.

The difference in rates of dosage rises to at least nine times as much in the case of cattle raised for beef, and may be as high as 16 times the rate of dosage per cow in the UK. There is currently a ban on imports of American beef throughout Europe, owing mainly to the free use of growth hormones in the US.

Higher use of antibiotics, particularly those that are critical for human health – the medicines “of last resort”, which the World Health Organisation wants banned from use in animals – is associated with rising resistance to the drugs and the rapid evolution of “superbugs” that can kill or cause serious illness.

The contrast between rates of dosage in the US and the UK throws a new light on negotiations on Brexit, under which politicians are seeking to negotiate trade deals for the UK independently of the EU. Agriculture and food are key areas, particularly in trading with the US, which as part of any deal may insist on opening up the UK markets to imports that would be banned under EU rules.

When negotiating outside the EU for a new trade deal, the UK will come under severe pressure to allow such imports. Over the summer, a row broke out over the potential for imports of US chlorinated chicken – bleaching chicken, according to experts in the UK, is a dangerous practice because it can serve to disguise poor hygiene practices in the food chain.

But Ted McKinney, US under-secretary for trade and foreign agricultural affairs, told an audience of British farmers last month he was “sick and tired” of hearing British concerns about chlorinated chicken and US food standards, providing further indication that the US government is likely to strike a hard deal on agricultural products as part of any trade agreement.

Ted McKinney


Ted McKinney speaks at the Oxford Farming conference in January. Photograph: David Hartley/Rex/Shutterstock

Antibiotic resistance can spread rapidly among herds and flocks, but can also be spread through eating affected food products, according to the World Health Organisation.

Antibiotic use in the US is three times higher in chickens than it is in the UK, double that for pigs, and five times higher for turkeys, according to research by the Alliance to Save Our Antibiotics, a UK pressure group, which based its report on new data that has recently become available through industry groups and government.

Suzi Shingler, at the Alliance to Save Our Antibiotics, said: “US cattle farmers are massively overusing antibiotics. This finding shows the huge advantages of British beef, which is often from grass-reared animals, whereas US cattle are usually finished in intensive feedlots. Trade negotiators who may be tempted to lift the ban on US beef should not only be considering the impact of growth hormones, but also of antibiotic resistance due to rampant antibiotic use.”

Nearly three quarters of the total use of antibiotics worldwide is thought to be on animals rather than humans, which raises serious questions over intensive farming and the potential effects on antibiotic resistance, which can easily be spread to people. Once resistance takes hold and drugs become ineffective, treating even common diseases becomes problematic. Dame Sally Davies, England’s chief medical officer, has warned that antibiotic resistance is one of the most severe threats facing humanity, and if strong action is not taken urgently that even routine operations such as hip replacements may become too dangerous.

The contrast between the US and the UK in antibiotic use in livestock is in part owing to the efforts of British farming organisations and retailers to cut the use of such medicines. The move to do so has picked up pace in recent years, as the scale of the superbug crisis has become clearer. Peter Melchett, policy director at the Soil Association, said: “UK farmers have finally begun to cut their antibiotic use, and the government needs to be careful it does not undermine this process by allowing imports from countries that are not respecting UK and EU standards.”

Family doctors working ‘beyond safe levels’, says GPs’ leader

As doctors describe dealing with up to 70 patients a day, college warns of risks to public health

Waiting room of GP practice


Patients face longer waits to see a GP, says the Patients Association. Photograph: Alamy


GPs across Britain are working above safe levels because of relentless and unmanageable workloads, leading doctors have warned.

Prof Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said that family doctors were “regularly working way beyond what could be considered safe for patients”, potentially jeopardising their own health and wellbeing.

Her comments were made in response to a survey by GP magazine Pulse. It heard from 900 GPs across the UK and found that each deals with 41 patients a day. The European Union of General Practitioners (UEMO), a leading forum of European family doctors, has said that seeing around 25 patients is safe.

The Pulse poll found that one in five family doctors (20%) deal with 50 daily patient contacts, which include face-to-face and telephone consultations, home visits and e-consultations. Some GPs told Pulse they have 70 contacts a day.

Prof Stokes-Lampard said: “GPs expect to be busy, and we are making more consultations than ever before as we strive to deliver the best possible care to all our patients who need it. But the workload at the moment is relentless and it’s taking its toll.”

One doctor, who reluctantly left a career carrying out 13- to 14-hour days as a partner for a more manageable workload as a salaried GP and 31 to 40 daily contacts, told Pulse: “I felt I was at a risk of making mistakes and causing potential harm to my patients and my career.”

Another spoke of one exceptional “horrendous” Monday where he had 71 contacts. Since then the practice has since increased the number of on-call doctors on Mondays to three.

Prof Stokes-Lampard said the survey backed up what the college has been saying for years – that many GPs are regularly working way beyond what could be considered safe for patients.

It was not necessarily the number of consultations, but the content of those consultations, she added. “Our patients are increasingly presenting with more complex, chronic conditions, many of which require much longer than the standard 10-minute appointment,” she said.

“Our workload needs to be addressed – it has risen at least 16% over the last seven years,” she added. “Yet the share of the overall NHS budget general practice receives is less than it was a decade ago, and our workforce has not risen at pace with demand.”

Dr Richard Vautrey, British Medical Association general practitioners committee chair, said: “We know that an unmanageable and unsafe workload is the primary reason behind doctors leaving general practice, which is leading to serious issues including practices closing to new patients and other surgeries closing entirely. This workload pressure also means GPs are increasingly suffering from burnout and patients are being put at risk of unsafe care.”

He urged the government to work with the BMA to come up with a longterm solution “to ensure the needs of a growing population with increasingly complex conditions can be met safely on the front line”.

Patients’ groups and MPs also expressed concern at the findings. Liz McAnulty, chair of the Patients Association, said: “We have gone past the point where efficiencies can be found, and firmly into territory where GPs’ workloads are unsustainable and where patients face growing waits to access GPs and greater risks to their safety.”

Shadow health secretary Jonathan Ashworth said the Royal College’s warning should serve as an urgent wake-up call to ministers. “The truth is, since 2010 years of severe underfunding of our NHS has left general practice squeezed with tired, overworked and overstretched GPs. We have lost 1,000 GPs in the past year.”

Family doctors working ‘beyond safe levels’, says GPs’ leader

As doctors describe dealing with up to 70 patients a day, college warns of risks to public health

Waiting room of GP practice


Patients face longer waits to see a GP, says the Patients Association. Photograph: Alamy


GPs across Britain are working above safe levels because of relentless and unmanageable workloads, leading doctors have warned.

Prof Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said that family doctors were “regularly working way beyond what could be considered safe for patients”, potentially jeopardising their own health and wellbeing.

Her comments were made in response to a survey by GP magazine Pulse. It heard from 900 GPs across the UK and found that each deals with 41 patients a day. The European Union of General Practitioners (UEMO), a leading forum of European family doctors, has said that seeing around 25 patients is safe.

The Pulse poll found that one in five family doctors (20%) deal with 50 daily patient contacts, which include face-to-face and telephone consultations, home visits and e-consultations. Some GPs told Pulse they have 70 contacts a day.

Prof Stokes-Lampard said: “GPs expect to be busy, and we are making more consultations than ever before as we strive to deliver the best possible care to all our patients who need it. But the workload at the moment is relentless and it’s taking its toll.”

One doctor, who reluctantly left a career carrying out 13- to 14-hour days as a partner for a more manageable workload as a salaried GP and 31 to 40 daily contacts, told Pulse: “I felt I was at a risk of making mistakes and causing potential harm to my patients and my career.”

Another spoke of one exceptional “horrendous” Monday where he had 71 contacts. Since then the practice has since increased the number of on-call doctors on Mondays to three.

Prof Stokes-Lampard said the survey backed up what the college has been saying for years – that many GPs are regularly working way beyond what could be considered safe for patients.

It was not necessarily the number of consultations, but the content of those consultations, she added. “Our patients are increasingly presenting with more complex, chronic conditions, many of which require much longer than the standard 10-minute appointment,” she said.

“Our workload needs to be addressed – it has risen at least 16% over the last seven years,” she added. “Yet the share of the overall NHS budget general practice receives is less than it was a decade ago, and our workforce has not risen at pace with demand.”

Dr Richard Vautrey, British Medical Association general practitioners committee chair, said: “We know that an unmanageable and unsafe workload is the primary reason behind doctors leaving general practice, which is leading to serious issues including practices closing to new patients and other surgeries closing entirely. This workload pressure also means GPs are increasingly suffering from burnout and patients are being put at risk of unsafe care.”

He urged the government to work with the BMA to come up with a longterm solution “to ensure the needs of a growing population with increasingly complex conditions can be met safely on the front line”.

Patients’ groups and MPs also expressed concern at the findings. Liz McAnulty, chair of the Patients Association, said: “We have gone past the point where efficiencies can be found, and firmly into territory where GPs’ workloads are unsustainable and where patients face growing waits to access GPs and greater risks to their safety.”

Shadow health secretary Jonathan Ashworth said the Royal College’s warning should serve as an urgent wake-up call to ministers. “The truth is, since 2010 years of severe underfunding of our NHS has left general practice squeezed with tired, overworked and overstretched GPs. We have lost 1,000 GPs in the past year.”

Family doctors working ‘beyond safe levels’, says GPs’ leader

As doctors describe dealing with up to 70 patients a day, college warns of risks to public health

Waiting room of GP practice


Patients face longer waits to see a GP, says the Patients Association. Photograph: Alamy


GPs across Britain are working above safe levels because of relentless and unmanageable workloads, leading doctors have warned.

Prof Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said that family doctors were “regularly working way beyond what could be considered safe for patients”, potentially jeopardising their own health and wellbeing.

Her comments were made in response to a survey by GP magazine Pulse. It heard from 900 GPs across the UK and found that each deals with 41 patients a day. The European Union of General Practitioners (UEMO), a leading forum of European family doctors, has said that seeing around 25 patients is safe.

The Pulse poll found that one in five family doctors (20%) deal with 50 daily patient contacts, which include face-to-face and telephone consultations, home visits and e-consultations. Some GPs told Pulse they have 70 contacts a day.

Prof Stokes-Lampard said: “GPs expect to be busy, and we are making more consultations than ever before as we strive to deliver the best possible care to all our patients who need it. But the workload at the moment is relentless and it’s taking its toll.”

One doctor, who reluctantly left a career carrying out 13- to 14-hour days as a partner for a more manageable workload as a salaried GP and 31 to 40 daily contacts, told Pulse: “I felt I was at a risk of making mistakes and causing potential harm to my patients and my career.”

Another spoke of one exceptional “horrendous” Monday where he had 71 contacts. Since then the practice has since increased the number of on-call doctors on Mondays to three.

Prof Stokes-Lampard said the survey backed up what the college has been saying for years – that many GPs are regularly working way beyond what could be considered safe for patients.

It was not necessarily the number of consultations, but the content of those consultations, she added. “Our patients are increasingly presenting with more complex, chronic conditions, many of which require much longer than the standard 10-minute appointment,” she said.

“Our workload needs to be addressed – it has risen at least 16% over the last seven years,” she added. “Yet the share of the overall NHS budget general practice receives is less than it was a decade ago, and our workforce has not risen at pace with demand.”

Dr Richard Vautrey, British Medical Association general practitioners committee chair, said: “We know that an unmanageable and unsafe workload is the primary reason behind doctors leaving general practice, which is leading to serious issues including practices closing to new patients and other surgeries closing entirely. This workload pressure also means GPs are increasingly suffering from burnout and patients are being put at risk of unsafe care.”

He urged the government to work with the BMA to come up with a longterm solution “to ensure the needs of a growing population with increasingly complex conditions can be met safely on the front line”.

Patients’ groups and MPs also expressed concern at the findings. Liz McAnulty, chair of the Patients Association, said: “We have gone past the point where efficiencies can be found, and firmly into territory where GPs’ workloads are unsustainable and where patients face growing waits to access GPs and greater risks to their safety.”

Shadow health secretary Jonathan Ashworth said the Royal College’s warning should serve as an urgent wake-up call to ministers. “The truth is, since 2010 years of severe underfunding of our NHS has left general practice squeezed with tired, overworked and overstretched GPs. We have lost 1,000 GPs in the past year.”

Family doctors working ‘beyond safe levels’, says GPs’ leader

As doctors describe dealing with up to 70 patients a day, college warns of risks to public health

Waiting room of GP practice


Patients face longer waits to see a GP, says the Patients Association. Photograph: Alamy


GPs across Britain are working above safe levels because of relentless and unmanageable workloads, leading doctors have warned.

Prof Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said that family doctors were “regularly working way beyond what could be considered safe for patients”, potentially jeopardising their own health and wellbeing.

Her comments were made in response to a survey by GP magazine Pulse. It heard from 900 GPs across the UK and found that each deals with 41 patients a day. The European Union of General Practitioners (UEMO), a leading forum of European family doctors, has said that seeing around 25 patients is safe.

The Pulse poll found that one in five family doctors (20%) deal with 50 daily patient contacts, which include face-to-face and telephone consultations, home visits and e-consultations. Some GPs told Pulse they have 70 contacts a day.

Prof Stokes-Lampard said: “GPs expect to be busy, and we are making more consultations than ever before as we strive to deliver the best possible care to all our patients who need it. But the workload at the moment is relentless and it’s taking its toll.”

One doctor, who reluctantly left a career carrying out 13- to 14-hour days as a partner for a more manageable workload as a salaried GP and 31 to 40 daily contacts, told Pulse: “I felt I was at a risk of making mistakes and causing potential harm to my patients and my career.”

Another spoke of one exceptional “horrendous” Monday where he had 71 contacts. Since then the practice has since increased the number of on-call doctors on Mondays to three.

Prof Stokes-Lampard said the survey backed up what the college has been saying for years – that many GPs are regularly working way beyond what could be considered safe for patients.

It was not necessarily the number of consultations, but the content of those consultations, she added. “Our patients are increasingly presenting with more complex, chronic conditions, many of which require much longer than the standard 10-minute appointment,” she said.

“Our workload needs to be addressed – it has risen at least 16% over the last seven years,” she added. “Yet the share of the overall NHS budget general practice receives is less than it was a decade ago, and our workforce has not risen at pace with demand.”

Dr Richard Vautrey, British Medical Association general practitioners committee chair, said: “We know that an unmanageable and unsafe workload is the primary reason behind doctors leaving general practice, which is leading to serious issues including practices closing to new patients and other surgeries closing entirely. This workload pressure also means GPs are increasingly suffering from burnout and patients are being put at risk of unsafe care.”

He urged the government to work with the BMA to come up with a longterm solution “to ensure the needs of a growing population with increasingly complex conditions can be met safely on the front line”.

Patients’ groups and MPs also expressed concern at the findings. Liz McAnulty, chair of the Patients Association, said: “We have gone past the point where efficiencies can be found, and firmly into territory where GPs’ workloads are unsustainable and where patients face growing waits to access GPs and greater risks to their safety.”

Shadow health secretary Jonathan Ashworth said the Royal College’s warning should serve as an urgent wake-up call to ministers. “The truth is, since 2010 years of severe underfunding of our NHS has left general practice squeezed with tired, overworked and overstretched GPs. We have lost 1,000 GPs in the past year.”

Family doctors working ‘beyond safe levels’, says GPs’ leader

As doctors describe dealing with up to 70 patients a day, college warns of risks to public health

Waiting room of GP practice


Patients face longer waits to see a GP, says the Patients Association. Photograph: Alamy


GPs across Britain are working above safe levels because of relentless and unmanageable workloads, leading doctors have warned.

Prof Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said that family doctors were “regularly working way beyond what could be considered safe for patients”, potentially jeopardising their own health and wellbeing.

Her comments were made in response to a survey by GP magazine Pulse. It heard from 900 GPs across the UK and found that each deals with 41 patients a day. The European Union of General Practitioners (UEMO), a leading forum of European family doctors, has said that seeing around 25 patients is safe.

The Pulse poll found that one in five family doctors (20%) deal with 50 daily patient contacts, which include face-to-face and telephone consultations, home visits and e-consultations. Some GPs told Pulse they have 70 contacts a day.

Prof Stokes-Lampard said: “GPs expect to be busy, and we are making more consultations than ever before as we strive to deliver the best possible care to all our patients who need it. But the workload at the moment is relentless and it’s taking its toll.”

One doctor, who reluctantly left a career carrying out 13- to 14-hour days as a partner for a more manageable workload as a salaried GP and 31 to 40 daily contacts, told Pulse: “I felt I was at a risk of making mistakes and causing potential harm to my patients and my career.”

Another spoke of one exceptional “horrendous” Monday where he had 71 contacts. Since then the practice has since increased the number of on-call doctors on Mondays to three.

Prof Stokes-Lampard said the survey backed up what the college has been saying for years – that many GPs are regularly working way beyond what could be considered safe for patients.

It was not necessarily the number of consultations, but the content of those consultations, she added. “Our patients are increasingly presenting with more complex, chronic conditions, many of which require much longer than the standard 10-minute appointment,” she said.

“Our workload needs to be addressed – it has risen at least 16% over the last seven years,” she added. “Yet the share of the overall NHS budget general practice receives is less than it was a decade ago, and our workforce has not risen at pace with demand.”

Dr Richard Vautrey, British Medical Association general practitioners committee chair, said: “We know that an unmanageable and unsafe workload is the primary reason behind doctors leaving general practice, which is leading to serious issues including practices closing to new patients and other surgeries closing entirely. This workload pressure also means GPs are increasingly suffering from burnout and patients are being put at risk of unsafe care.”

He urged the government to work with the BMA to come up with a longterm solution “to ensure the needs of a growing population with increasingly complex conditions can be met safely on the front line”.

Patients’ groups and MPs also expressed concern at the findings. Liz McAnulty, chair of the Patients Association, said: “We have gone past the point where efficiencies can be found, and firmly into territory where GPs’ workloads are unsustainable and where patients face growing waits to access GPs and greater risks to their safety.”

Shadow health secretary Jonathan Ashworth said the Royal College’s warning should serve as an urgent wake-up call to ministers. “The truth is, since 2010 years of severe underfunding of our NHS has left general practice squeezed with tired, overworked and overstretched GPs. We have lost 1,000 GPs in the past year.”

Family doctors working ‘beyond safe levels’, says GPs’ leader

As doctors describe dealing with up to 70 patients a day, college warns of risks to public health

Waiting room of GP practice


Patients face longer waits to see a GP, says the Patients Association. Photograph: Alamy


GPs across Britain are working above safe levels because of relentless and unmanageable workloads, leading doctors have warned.

Prof Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said that family doctors were “regularly working way beyond what could be considered safe for patients”, potentially jeopardising their own health and wellbeing.

Her comments were made in response to a survey by GP magazine Pulse. It heard from 900 GPs across the UK and found that each deals with 41 patients a day. The European Union of General Practitioners (UEMO), a leading forum of European family doctors, has said that seeing around 25 patients is safe.

The Pulse poll found that one in five family doctors (20%) deal with 50 daily patient contacts, which include face-to-face and telephone consultations, home visits and e-consultations. Some GPs told Pulse they have 70 contacts a day.

Prof Stokes-Lampard said: “GPs expect to be busy, and we are making more consultations than ever before as we strive to deliver the best possible care to all our patients who need it. But the workload at the moment is relentless and it’s taking its toll.”

One doctor, who reluctantly left a career carrying out 13- to 14-hour days as a partner for a more manageable workload as a salaried GP and 31 to 40 daily contacts, told Pulse: “I felt I was at a risk of making mistakes and causing potential harm to my patients and my career.”

Another spoke of one exceptional “horrendous” Monday where he had 71 contacts. Since then the practice has since increased the number of on-call doctors on Mondays to three.

Prof Stokes-Lampard said the survey backed up what the college has been saying for years – that many GPs are regularly working way beyond what could be considered safe for patients.

It was not necessarily the number of consultations, but the content of those consultations, she added. “Our patients are increasingly presenting with more complex, chronic conditions, many of which require much longer than the standard 10-minute appointment,” she said.

“Our workload needs to be addressed – it has risen at least 16% over the last seven years,” she added. “Yet the share of the overall NHS budget general practice receives is less than it was a decade ago, and our workforce has not risen at pace with demand.”

Dr Richard Vautrey, British Medical Association general practitioners committee chair, said: “We know that an unmanageable and unsafe workload is the primary reason behind doctors leaving general practice, which is leading to serious issues including practices closing to new patients and other surgeries closing entirely. This workload pressure also means GPs are increasingly suffering from burnout and patients are being put at risk of unsafe care.”

He urged the government to work with the BMA to come up with a longterm solution “to ensure the needs of a growing population with increasingly complex conditions can be met safely on the front line”.

Patients’ groups and MPs also expressed concern at the findings. Liz McAnulty, chair of the Patients Association, said: “We have gone past the point where efficiencies can be found, and firmly into territory where GPs’ workloads are unsustainable and where patients face growing waits to access GPs and greater risks to their safety.”

Shadow health secretary Jonathan Ashworth said the Royal College’s warning should serve as an urgent wake-up call to ministers. “The truth is, since 2010 years of severe underfunding of our NHS has left general practice squeezed with tired, overworked and overstretched GPs. We have lost 1,000 GPs in the past year.”