Could health service reforms make general practitioners ill?

Purpose -- This is an unprecedented period of organisational change in English primary care. The aim of this paper is to draw on findings from the most recent period of rapid change for primary care, with lessons that may have profound implications for the implementation of forthcoming Health Service reforms. Design/methodology/approach -- Front line practitioners from two primary care Trusts were surveyed in terms of their reaction to change and those questionnaire findings were used to design interviews for a cross-section of staff with varied responsibilities. Findings -- General practitioners (GPs) differed from all other staff groups. Most GPs found change unwelcome and stressful, especially if individually they felt they had little influence on an externally imposed re-organisation. They also felt accumulated changes had distanced them from patient care which had been a major motivating factor. Originality/value -- The reforms currently proposed in the NHS and Social Care Bill compel GPs to take on unfamiliar commissioning roles, in new organisational structures. Implementation of the Bill needs to take into consideration the health impact on key medical colleagues, if it ignores the work satisfaction GPs derive from clinical care and the mental health consequences of loss of control over working practice. [ABSTRACT FROM AUTHOR]