Paul McNamara is a Principal GP in Glasgow and honorary clinical lecturer at the University of Glasgow
Winters in Glasgow can feel bleak. Sometimes walking into clinic feels like wading through treacle — not because of the patients, but because of the quiet knowledge of the admin waiting on the other side of every consultation. The blood results, the letters, the safety-netting, the coding, the reflections for appraisal. A mountain that never really shrinks, no matter how hard you work.
And yet this is the job I love — the people, the continuity, the slow relationships built over years. But over time a second job attached itself to the first: the administrative after-life of every decision. Necessary, important, but increasingly overwhelming.
The evidence now mirrors what many of us have felt for years. Burnout among GPs remains at crisis levels; cognitive load keeps rising; continuity slips as the work fractures into tasks.1-3 None of this surprises those working in Deep End practice. The complexity, the instability, the quiet human pressures that never show up in the notes — this is the backdrop to every clinic. We feel the strain long before it appears in a report.
Burnout among GPs remains at crisis levels; cognitive load keeps rising; continuity slips as the work fractures into tasks.
There was no dramatic moment for me. No collapse, no epiphany. Just a slow, daily awareness that the space to think clearly was eroding. Even on the good days — when a family steadied or a long-term patient found some peace — the unseen work only grew. The clinical part remained meaningful; everything wrapped around it felt heavier.
Late at night, once my daughters were asleep, I found myself turning the problem over in my mind. Not as an entrepreneur — the word never felt like mine — but as a clinician trying to keep the work sustainable. What if we could capture the learning that happens inside the consultation? What if the admin could stop fighting against the medicine?
Those quiet questions became the beginning of Umbil, a small digital tool developed in response to the administrative pressures described in this article. I mention it for context rather than promotion. There are no external investors and no commercial funding associated with its development.
It wasn’t born from ambition. It began as an attempt to carve out a small space where thinking could happen more easily: a place to ask a clinical question, receive concise guidance drawn from trusted UK sources, and immediately turn that into something useful — a line of safety-netting, a referral draft, a CPD entry. Not a grand solution, just a way of easing the friction between clinical reasoning and the paperwork that shadows it.
And I didn’t build it alone. A co-founder who understands the reality of training, a developer who turned scribbled ideas into structure, and students who tested and refined the early versions all helped turn a personal coping mechanism into a shared project.
I’m a reluctant founder. Putting your head above the parapet is unnerving, especially for someone who would happily stay in the background — teaching, writing, working quietly in a Deep End surgery. Being visible has never come naturally. This never came easy. I almost didn’t apply to medical school because the idea of public speaking felt unbearable. And yet, slowly, the work pulled me into roles I never expected to take on.
AI sits quietly in the background of this story — not as a promise of transformation, but as a tool that, used carefully, might return a little cognitive space to clinicians who need it. The digital shift in medicine is already here: transcription, summarising guidance, structuring letters, reducing duplication. None of it replaces judgement. But when used thoughtfully, it might protect it.
Umbil emerged from that reality — from the weight of modern generalism, from the tension between ever-rising demand and ever-shrinking time, from the hope that we might make the work more bearable for ourselves and for those coming after us.
My hope is modest. No digital tool will fix the NHS or reverse the structural pressures driving burnout. But perhaps we can reclaim small pockets of clarity.
My hope is modest. No digital tool will fix the NHS or reverse the structural pressures driving burnout. But perhaps we can reclaim small pockets of clarity. Perhaps trainees will feel less overwhelmed as they navigate their first months in practice. Perhaps the mental clutter surrounding the work might lift, even slightly.
Innovation at the Deep End often begins this way — not with grand visions, but with quiet acts of survival. Small attempts to make the work feel a little more human. And as medicine edges further into a digital age, it’s hard not to feel that we’re standing at the beginning of something larger: a moment where thoughtful, clinician-led innovation might help protect the parts of practice we value most.
If I’m a founder, I’m a reluctant one — but perhaps this is what the future of general practice will require of us.
References
1. British Medical Association. Caring for the mental health of the medical workforce. 2019. https://www.bma.org.uk/media/ckshvkzc/bma-mental-health-survey-report-september-2024.pdf [accessed 29/1/26]
2. Whitehead IO, Moffatt S, Jagger C, Hanratty B. A national study of burnout and spiritual health in UK general practitioners during the COVID-19 pandemic. PLoS One. 2022 Nov 2;17(11):e0276739. doi: 10.1371/journal.pone.0276739. PMID: 36322555; PMCID: PMC9629610.
3. British Medical Association. New BMA survey highlights worrying trends of burnout among GP registrars. 2024. https://www.bma.org.uk/bma-media-centre/new-bma-survey-highlights-worrying-trends-of-burnout-and-future-concerns-from-gp-registrars [accessed 29/1/26]
Featured Photo by Glenn Carstens-Peters on Unsplash
