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Independents' Day

Pulse 2018 review: The growing attraction of early retirement

the great escape cover pulse final 3x2

the great escape cover pulse final 3x2

Plans to increase the GP workforce seem doomed to fail.

With a year left to reach the Government's target of having trained and retained an extra 5,000 GPs since September 2015, overall numbers are in fact falling.

As of September 2018, the number of full-time equivalent GPs was still 387 below the 34,592 in the workforce in September 2015.

Pulse revealed back in February that a compelling reason for this trend is more GPs are retiring and drawing a pension at a younger age.

Official NHS pension scheme figures showed that in 2016-17 some 721 GPs under 60 drew their pension for the first time, a 41% of increase on the 2011-12 figure of 513.

The average age of pension claimants fell from 60.4 years to 58.5 years in the same period.

While the latest figures on the number of GPs retiring early show some signs of improvement - in 2017-18, a total of 588 drew their pensions before age 60 - GPs have still warned that unless the problems of workload and stress were addressed GPs would continue to opt for early retirement.

And the upshot? Despite more trainees than ever before entering the profession, incentive schemes to bring leavers back into it, and the NHS boosting numbers of GPs from overseas, early retirees are tipping the balance the other way.

As a result, pressures become even greater on GPs left holding the baby, as they try to keep their practices together. 

In some areas, supply fails to meet demand and practices end up closing, leaving thousands without a GP.

In others, workload is reaching potentially dangerous levels – with GPs having 60% more patient contacts per day than the European Union of General Practitioners considers safe.

Paradoxically, workload pressures are not just a consequence of GPs retiring or cashing in their pensions before their turn 60. They are also the leading cause.

Early retirees cite workload above all else as a factor in their decision, and half of respondents to a Pulse survey said work stress affects their ability to care for patients.

Other reasons GPs give for retiring early include: poor mental health; high indemnity costs and taxation; regulatory burden; a 15% annual slash in seniority payments (ahead of their abolition in the next year); and fear of being the ‘last (wo)man standing’, which would see them lumbered with premises and staff liabilities with no one rising through the ranks to take them over.

Earlier this year, the BMA said it was looking at potential solutions, including launching an initiative aimed at dissuading GPs from taking early retirement.

But this will only work if the bigger issue of making general practice an attractive place to work is addressed - so that more young doctors enter the profession, and fewer leave before their time.

Readers' comments (19)

  • 48 now. FTE. 20 years GP experience. Will reach LTA at 55. Work life balance is terrible. Patient and job demands increase day on day. Criticism of me, my place of work, my profession, comes daily from all sources. Administrative hoops to jump through proliferate like rabbits. Plan to retire and retrain in 8 years. It can't come soon enough. Sound familiar to anyone else?

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  • Sadly, very familiar. And the chances of "the powers that be" being able to identify let alone address effectively all of the multiple factors leading to this perfect storm are minimal, I'm afraid.
    The individual personal tragedies are heart-breaking. But the bigger picture - in terms of how we cope without effective primary care - is even more scary. And no, the answer does NOT lie in Working at Scale, or Working Smarter, or AI, or telemedicine.
    No-one cares. No-one wants to listen. Plenty want to gloss over it. Plenty are invested in the very processes that are weighing us down. And new initiatives are generally as helpful as throwing a concrete lifebelt to a drowning GP.

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  • Just in case anyone needed an extra push.
    Those doing 24 hour retirement and then returning to work will find from April their pay packets might be 40% increase.

    Much more likely is a reduction in sessions. A 7 session partner, taking 24 hour retirement (or just opting out of the pension scheme because they reaced their lifetime allowance) will find they earn, after pension contributions, exactly the same on 5 sessions.

    Once you include lower taxation it might be closer to 4 sessions.

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  • I had had the impression that changes in the pension system - & LTA - was a contributory factor to taking the pension early - which no longer requires retirement from work - or even change in role.
    How do taking the NHS pension am
    and leaving the workforce (including locum or non-GP work) correlate?
    DOI - retired - late - 31.3.13 - so escaped the effects of HSCA 2012

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  • And things could be so easily turned around. Humanise the CQC- make their visits essentially formative on a five yearly basis. Reinstate greatly enhanced seniority, stop messing about with indemnity- just cover it. Instruct the CCGs that the only interventions that they are allowed to make must be helpful - all these are very easy low hanging fruit. Widen the gap between partner and salaried income.

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  • 'Attraction' is a misnomer. Highly qualified professionals having to give up a profession most of them are passionate about is tragic - retirement is accepting defeat with the solace that you did survive the onslaught unleashed by the unscrupulous NHS establishment.

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  • End of the line?

    Love the Steve McQueen bike jump pic ....
    unfortunately am too young to retire...
    More appt pic
    Steve McQueen bouncing the ball in the cooler...

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  • End of the line?

    Will likely have to do a "Shawshank redemption"... crawl through miles of sewage ..

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  • I retired from the NHS as a full time partner aged 50, then had a portfolio career until 70 never regretted it.

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  • Now do 6 sessions down from 9 and earn more. The 4 days off in a row are great, the 3 days in a row are a chore......but just about worth it.

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