This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

Gold, incentives and meh

Tens of thousands of GPs on brink of early retirement, BMA finds

A major BMA survey has revealed that six in ten GPs are considering early retirement and more than half say their morale is either ‘low’ or ‘very low’, in findings that will form the core of the profession’s fight back against Government cuts to general practice.

The survey, which involved 420 GP respondents, also revealed that almost half the respondents having already made changes or planning to make changes to their work life balance.  

GPC chair Dr Chaand Nagpaul said he would use the ‘shocking’ results to lobby ministers on the impact of the ongoing drive to keep patients out of hospital, and highlight how funding cuts are threatening to overwhelm general practice.

A separate RCGP poll of patients showed almost two-thirds of respondents believe the sheer volume of consultations taking place are a threat to patient care. RCGP chair Dr Maureen Baker said over the weekend that general practice is in real danger of ‘extinction’.

Pulse recently revealed that GPs in some parts of England are currently working for free as a result of the changes made by the imposed 2013/14 GP contract, and a series of below inflation pay uplifts. The 0.28% pay uplift for 2014/15 has also reduced the morale of GPs.

The survey, which the BMA said is accurate to within 3.3% at a 95% confidence level, found that 56.8% had considered retiring early, while 27.7% had thought of leaving the profession.

Furthermore, 47% said they had already made changes, or are in the process of planning for a change to their work life balance. Only 14.1% said they had not considered a move away from their current role.

When asked how they would describe their current level of morale, 39% answered ‘low’, and 16% said ‘very low’. Only 1% said it was ‘very high’, while 13% said it was ‘high’.

It also found that 54.1% of GPs described their current workload as ‘unmanageable or unsustainable’.

Dr Nagpaul said general practice was in danger of becoming ‘overwhelmed’.

He told Pulse: ‘It is shocking that so many GPs intend to retire early. The Government has to act to retain the workforce – by making the workload manageable and providing enough resources. GPs are overstretched and overwhelmed, and there is not the capacity to deal with the volume of work that is moving out of hospital.’

Dr Nagpaul added: ‘We are seeing morale dip to a level that I cannot remember in my 25 years as a GP.’

One survey respondent, Norfolk-based GP Dr John Harris-Hall, said of his decision to retire early: ‘The increasing demand and workload pressure are leading to low morale and stress, causing many GPs like myself to leave the profession. I am sad to retire early but I feel there is no other choice. Enough is enough.’

The RCGP poll of 1,007 patients found that 62% believe that the number of patient consultations GPs conduct each day – which the RCGP estimated at between 40-60 in most cases – is a threat to the standard of care they can provide to patients.

The poll, conducted by ComRes, also found that 28% of those surveyed could not get an appointment in the same week when they last tried to book an appointment.

Dr Baker said: ‘General practice as we know it is now under severe threat of extinction. It is imploding faster than people realise and patients are already bearing the brunt of the problem. This will only get worse unless urgent action is taken to redress the huge and historic imbalance in funding.’

Related images

  • Dr Chaand Nagpaul 2013 - online

Readers' comments (134)

  • Whats the point of writing this here! We all know the problem at coal face.
    Publish this in national papers.
    BM should take whole page adverts and involve in group discussions etc to promote this.

    Unsuitable or offensive? Report this comment

  • The people in power ( not necessarily the government ) require primary care to fail. You cannot successfully privatise health care with an effective and low cost public funded service in position . It must be allowed to collapse . Large health corporations will move in and fill the gap ; much more expensively of course . The new health bill and current provision for general practice all points to this scenario. Anyone who has sense recognises this and is getting ready to bail. To prevent this the general public need to be aware of our worth. Judging by the comments made on the BBc health section ot the news everyone feels we have a simple job and are over paid for doing it . The truth of course is very different but corporate owned media will not put this forward. The BMa need to show what a fantastically cost effective service we provide .

    Unsuitable or offensive? Report this comment

  • Has this BMA survey questioned only GPs who still retain their BMA membership? If so then you will find the percentage planning to bail out early is even higher. I am speaking as a disillusioned GP who cancelled my BMA membership (of more than 20 years) last year due to their ineffectual support of grassroots GPs. I have actioned plans to leave in a few years if not earlier. I feel saddened this is happening to our profession.

    Unsuitable or offensive? Report this comment

  • DOH and Jeremy Hunt are "GP recruitment and retention deniers". They, like some in society, seem to believe that if you deny something for long enough then it becomes reality.

    Unsuitable or offensive? Report this comment

  • It is a bit like the years leading up to the 2008 financial crisis. Those who warned of it were labelled heretics and nut jobs. Human nature means that when everything is still above water, nobody can see the iceberg.

    Unsuitable or offensive? Report this comment

  • Actually Dr Baker did yesterday - was on the BBC new website etc. Credit where it's due (not BMA though!) but I fear it's too little too late.

    Unsuitable or offensive? Report this comment

  • I am looking forward to saying those infamous words "I told you so!!".
    The Daily Mail will be leading with "Evil medical students refuse to enter General Practice" and "Greedy and evil GPs have forced Jeremy Hunt to destroy General Practice as part of a plan of world domination and are in cahoots with aliens"

    Unsuitable or offensive? Report this comment

  • Despite Dr Bakers warnings of the future state of General Practice I can only laugh when I read some of the media comments:
    Daily Mail -"According to the BMA, more than half of GPs are considering early retirement because their ‘morale’ is so low.
    Is it too much to ask that they might consider the ‘morale’ of fed-up patients who pay their large salaries – and reinstate a proper round-the-clock service?" and The Telegraph: " GPs need to demonstrate that they are in a position to take on the function of hospitals. People will not find Dr Baker’s protestations convincing if more is not done to provide better out-of-hours care and greater flexibility with bookings"

    So in essence when the public are continually fed this type of information, we as a profession will continue vote with our feet and leave our unacceptable work situation. The British public are loosing a valuable asset. They won't realise how good it was till its gone.

    Unsuitable or offensive? Report this comment

  • They're planning to retire early because they can afford to retire early.

    Ask anyone in the population if they wouldn't like to be making plans to retire early - what do you think they'd say?

    Unsuitable or offensive? Report this comment

  • In some ways we need the collapse to happen, people just do not get how good they have it. We as Dr's as a whole have self sacrificed to a degree that other professionals no not believe.
    I want NHS primary care to survive but am shocked at how evil the political journalistic class is. Short term benefit is all that they care about.
    That is not to say we have got a far way to go to get our house in order. the fact we ignore continuity of care issues is a major part of the problem. sticking our heads in the sand in not an answer

    Unsuitable or offensive? Report this comment

  • Unfortunately, if you spin this through the national press then the outcome will be the same as Anon-11:19.

    Jealousy that GPs can retire early rather than fear of a primary care collapse.

    Unsuitable or offensive? Report this comment

  • Easy to stop them retiring just take away there fat cat pensions paid by the struggling tax payer. And yes I do reed the Daily mail.

    Unsuitable or offensive? Report this comment

  • This is not thought through at all. What would be the point in putting more money into primary care as there are not GPs to recruit?
    The government has made it clear it is not spending more on primary care until it can work at larger scale. This is the issue which needs to be addressed not simply asking for more money

    Unsuitable or offensive? Report this comment

  • Anon 11:28 - yes, I can see you do infact "reed" the daily mail!

    We need 2 different fundings. One is to sustain what we already provide i.e. Money in keeping with inflation and rise in clinical activities. Without this rise you would have to accept the service will decrease. The other is investment to improve service. This will have to happen in addition to the above. There is only so much we can improve care with innovation and efficiency.

    Unsuitable or offensive? Report this comment

  • We can`t fight with the media against us. Including the " non- bias" BBC, who rarely put GP`s in a good light, or tuck the story away like this-Note the Bias in the Health correspondents blurb.
    http://www.bbc.co.uk/news/health-26703519

    Unsuitable or offensive? Report this comment

  • Interesting, all this bluster but no-one advocating the traditional way of getting politicians to listen-industrial action.
    The fault, dear Brutus, lies in ourselves...............

    Unsuitable or offensive? Report this comment

  • "Easy to stop them retiring just take away there fat cat pensions paid by the struggling tax payer. And yes I do reed the Daily mail".

    Cant spell, no idea about grammar and no idea that GPs finance their pension entirely themselves, the tax payer is not involved. Dementia screening might be a good idea after all.

    Unsuitable or offensive? Report this comment

  • Could a boycott of OOH work be organised ? It's not contracted work, it would be a high visibility protest and would likely have a rapid effect as A+E gets embarrassingly busy. According to the daily mail we don't do this work anyway so who would they blame .

    Unsuitable or offensive? Report this comment

  • This comment has been deleted

    Unsuitable or offensive? Report this comment

  • 11.28. What does everyone else in society owe you??...answer....NOTHING. You are "entitled" to NOTHING. Your deluded sense of entitlement is not only baffling but perhaps indicates a personality disorder??

    Unsuitable or offensive? Report this comment

  • This comment has been deleted

    Unsuitable or offensive? Report this comment

  • Dear General Public
    We do care for and about you very much. I am, so sorry that you are being "hodwinked" by The Daily Mail into hating GPs. Just like January sales remember the phrase "When they are gone, they are gone". If you end up looking for someone to blame, look no further than THE DAILY MAIL, the newspaper who like multi-millionaires and private healthcare for the rich and who ridicules and manipulates the man in the street in a cynical and predatory way.

    Unsuitable or offensive? Report this comment

  • And PULSE magazine....have a backbone and allow these negative comments about The Daily Mail. "Man up" and stop grovelling.

    Unsuitable or offensive? Report this comment

  • Dr Mustapha Tahir

    Hopefully the focus will shift on retention and not just recruitment alone. The society does need the experience of older GPs.

    Unsuitable or offensive? Report this comment

  • and these figures do not even include this who, like me, have already gone!

    Unsuitable or offensive? Report this comment

  • Took Early Retirement

    Yup, well, Mrs G and I are off, as we've said. I gather the Daily Wail's take on it is that GPs should NOT retire but take into account their patients' wants and go back to working 24 hours.
    Jerks!

    Unsuitable or offensive? Report this comment

  • Its no wonder we want to go when you have just signed away our seniority that we have worked 30 years for! Hardly motivating to stay and work I think

    Unsuitable or offensive? Report this comment

  • GPs really need to work together to publicise themselves better.

    The public at large do not undestand the subtleties of the contracts and responsibilites. As long as this confusion remains they will always be an easy target in the press.

    Like increments for the NHS, nobody understands really understood whether it was a pay rise or a withholding of pay based on experience, so any industrial action would be laughed down.

    Pick your fights, don't get dragged into Daily Mail mudslinging.

    Unsuitable or offensive? Report this comment

  • This comment has been deleted

    Unsuitable or offensive? Report this comment

  • Bob Hodges

    I'm starting to feel that the coming catastrophic collapse of NHS is a preice worth paying to see the look on the faces of the Daily Mail Readership.

    Schadenfreude Enhanced Service!

    Unsuitable or offensive? Report this comment

  • Took Early Retirement

    Yes Bob, I forgot to say, this is a GOOD NEWS story!

    Unsuitable or offensive? Report this comment

  • Some improvement of morale could be obtained by putting all QOF money into the global sum , stopping revalidation and dropping CQC . Two weeks without OOH should do it . The changes wouldn't cost HMG anything.

    Unsuitable or offensive? Report this comment

  • Keith Taylor

    Based upon our client base I’m surprised the % is not higher. When it becomes obvious that the expected budget savings can’t be made and GPs are blamed then this will start the exodus. We have done numerous projections of clients pensions and when is the best time to retire to avoid the continued attack on GP pensions.

    Unsuitable or offensive? Report this comment

  • Bob Hodges

    Stopping OOH would also make it clear just how dependent we upon '9 to 5 fatcat' GPs to also provide the vast majority of OOH capacity to.

    I might just have to give up OOH anyway as I can't get out of this bloody surgery early enough to go up to the OOH centre.

    Unsuitable or offensive? Report this comment

  • It's not just about the Daily Mail.If you read the comment sections in the Guardian and Daily Telegraph,the overwelming majority are anti-GP.We just can't shake off our public image as overpaid,underqualified failed hospital doctors.

    Unsuitable or offensive? Report this comment

  • I agree , time to go asap as can at 57 for me in 2 months.

    Unsuitable or offensive? Report this comment

  • if the service is cheap and effective there will always be more punters than we can cope with .
    There was a young GP from Crewe
    Who did all a doctor could do.
    I'll cure you for free
    And make the blind see
    Now get to the back of the queue.

    Unsuitable or offensive? Report this comment

  • Well I made it to 59, and next Monday is my big R............before tax changes start to take 55% of my hard-paid Added years. I never thought I would have to make a quick exit!

    Unsuitable or offensive? Report this comment

  • Una Coales

    The public didn't even get a chance to save the NHS with copayments like in Australia, New Zealand, Ireland and Canada. Why only save NHS dentistry? Now the public will end up paying expensive annual private health insurance premiums and be restricted in choices of specialists and coverage and GPs will be made to work around the clock for HMOs/APMS for as little as they can get away with paying a fully qualified family physician.

    Our finest GPs who are too young to retire early and too grounded to emigrate, will be stuck between working as a salaried GP on min doctor's pay for HMOs or brave a new world in private practice.

    Unsuitable or offensive? Report this comment

  • Bob Hodges

    I'm not sure I'd be that pessimistic Una.

    When was the last time an insurance company oferred me £x for a report, and when I said 'actually my rate is £2x' then didn't cough up no questions asked.

    There are not enough family docotrs full stop. Even if the CSA debacle hadn't mugged the IMGs there still wouldn't be enough GPs. There certainly aren't enough GPs to train enough GPs to rectify the situation.

    HMOs know better than the NHS that everytime a GP DOESN'T refer to acute hospital, they've saved the system thousands of pounds, and roughly 10 times what the doctor was paid that day on average.

    A market might just break out in our skills and labour.

    Unsuitable or offensive? Report this comment

  • One huge reason for the enormous workload is the vast shift of chronic illness management from hospital to primary care without the resources following. Why is this not quantified and publicised. Extra funding would be spent on larger premises filled with more GPS working at a safer pace. Any collapse of General practice would see this work go back to hospital at a vastly greater cost.

    Unsuitable or offensive? Report this comment

  • 5.39pm - this is the whole point. The NHS wants to bring work out of hospital but to larger primary care units not the small practices which exist today. There are lots of financial resources available

    Unsuitable or offensive? Report this comment

  • HMO's would require 3x the number of Gp's just to cover sick leave . We can all sign each other off work .

    Unsuitable or offensive? Report this comment

  • Will the last doctor to leave General Practice please turn out the lights.

    Unsuitable or offensive? Report this comment

  • Una Coales

    HMOs may own the acute hospitals too. The insurance premiums limit what pts may be referred for without paying a top up. The more your premium, the more coverage. Any referral needs pre approval from a central HMO referral unit. If you think the NHS is tough as a gatekeeper, wait until you work for a HMO. You will be the one telling pts that the central referral unit declined a referral request or wishes to charge the pt ££££ extra.

    Unsuitable or offensive? Report this comment

  • Una Coales

    @5:44 pm sick notes for HMO GPs? You forgot the unilateral variation rule of salaried GP contracts. Too many days off sick and a contract can be unilaterally rewritten to make your pay so tiny you would need a magnifying glass to read the fine print.

    Unsuitable or offensive? Report this comment

  • So we keep writing sick notes and see who cracks first .

    Unsuitable or offensive? Report this comment

  • Why don`t we take an action day?
    Not strike action- but a day of just telling our patients how much it would cost them to see a Dr if it all fails. knowing it would be say x pounds to see a Dr, and y pounds for the private script, just as it does to see a dentist. If several GP`s did that and had a campaign to say Gp`s are in danger of going bankrupt/recruiting/burnout , and this is what could happen, that may work.
    Oh and to the Dily Mail troll , please go away this is a profesiionals forum.

    Unsuitable or offensive? Report this comment

  • Cheer up and google"the daily mail song" by dan&dan it not just us that thinks it is a useless rag

    Unsuitable or offensive? Report this comment

  • Una Coales

    I am in full support of BMA industrial action! The GPs of 1966 were brave enough to threaten to all leave the NHS for private practice and were rewarded by PM Harold Wilson with a 30% increase in pay and a 1966 Doctors' Charter. http://news.bbc.co.uk/onthisday/hi/dates/stories/may/4/newsid_2502000/2502925.stm

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say