HEALTH AT WORK IN THE GENERAL-PRACTICE

Background. Poor mental health and high stress levels have been report ed in staff working in general practice. Little is known about how pra ctices are tackling these and other issues of health at work in the ab sence of an established occupational healthcare service. Aim. To estab lish the extent of knowledge and good practice of health at work polic ies for staff working in general practice. Method Practice managers in 450 randomly selected general practices in England were interviewed b y telephone, and the general practitioner (GP) with lead responsibilit y for workplace health in the same practice was surveyed by postal que stionnaire We surveyed the existence and implementation of practice po licies, causes and effects of stress on practice staff, and agreement between practice managers and GPs on these issues. Results. Seventy-on e per cent of GPs and 76% of practice managers responded, with at leas t one reply from 408 (91%) practices and responses from both the pract ice manager and GPs from 252 (56%) practices. Seventy-nine per cent of practices had a policy on monitoring risks and hazards. The proportio n of practices with other workplace health policies ranged from 21% (p olicy to minimize stress) to 91% (policy on staff smoking). There was a tendency for practices to have policies but not to implement them. T he three causes of stress for practice staff most commonly cited by bo th GP and practice manager responders were 'patient demands', 'too muc h work', and 'patient abuse/aggression'. Sixty-five per cent of GPs fe lt that stress had caused mistakes in their practices. Although there was general agreement between the two groups, there was a considerable lack of agreement between responders working in the same practices. C onclusions. The study revealed substantial neglect of workplace health issues with many practices falling foul of health and safety legislat ion. This report should help general practices identify issues to tack le to improve their workplace health, and the Health at Work in the NH S project to focus on areas where their targeted help will be most wor thwhile.