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GP numbers down because of 'millennial' working hours, says training chief

Young GPs are willing to work fewer hours than their older counterparts, resulting in the equivalent of 10% fewer doctors in the workforce, the head of HEE has said.

Professor Ian Cumming, chief executive of HEE, told delegates at NHS Confederation’s conference that the Government has had to revise down its estimates on the number of GPs in the workforce – as reported previously by Pulse.

But he added that this was partly due to the changes in working patterns for younger GPs.

Professor Cumming told delegates that GPs used to work on average the equivalent of 0.9 WTE, but this has dropped to 0.83 as more millennial GPs enter the workforce.

As a result of this, the number of full-time-equivalent doctors in the system has reduced.

He said: ‘Our workforce are choosing to work fewer hours. Part of this is because of generation Y and Z and millennials starting to come through, who are increasingly not wanting to work the same number of hours that many of the baby boomers and generation X want to work.’

The HEE chief executive said that the figures from NHS Digital mean that the NHS is getting 10% fewer clinical hours out of each GP over the past few years, which equates to 10% fewer GPs in the workforce.

Professor Cumming said: ‘Another way of putting that is you’re dealing with 10% more patients, you’re under 10% more pressure.’

The trend is likely to continue and grow, he added, ‘so we have to be mindful of that, that we aren’t getting the same number of hours out of every clinician as we used to’.

Professor Cumming also addressed the Government’s plan to increase the number of medical students by 1,500 by 2019.

He said 500 of those places have been allocated, with 1,000 more to start in 2019.

But he cautioned delegates not to get ‘carried away about the immediate benefits of that’, adding that it is ’11 years before these people are GPs’.

He said: ‘We need to do it because we need to get our workforce right but it’s not a short-term fix.’

Readers' comments (30)

  • Everyone is trying to find an answer as to why no one wants to do general practice . They are looking at the ceiling then looking at the floor but willfully ignoring the huge grey large eared animal in the middle of the room.

    It needs spelling out. No one wants to do a job that bears a suspicious resemblance to the steaming mound that has just dropped out of the elephant's backside.

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  • Ian Cumming - I sincerely hope you are reading this.

    How dare you covertly imply that the new generation of GPs does not wish to work as hard as their predecessors.

    Let me fill in the cracks with a dose of reality, shall I?

    Firstly, the job has mushroomed in volume and intensity such that no-one can cope with working 8 or 9 sessions any more. Averaging around 6 hours per session, this would mean working a 55 hour week. Do you honestly think anyone is capable of this long term?

    Secondly, if you want to look for a solution to the workforce crisis - I can give you one in a nutshell. PAY OUR INDEMNITY.

    Clinical work no longer pays. Indemnity is sky rocketing so we are all reducing our clinical sessions.

    It's so obvious it's heartbreaking

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  • Sorry pulse but unless I misunderstood the article, there is nothing in there about "shorter hours"

    GPs are doing less WTE (i.e. sessions, rather then actual hours) and you might find as we are working longer, 0.83WTE today may not be that much different to 0.9WTE 13 years ago. With 25% less pay.

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  • Come on Proff how many sessions do your do o the front line!

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  • Above is part of the reason.

    I just want more money. For me the tax system is the main disincentive to working longer. You get destroyed above £100k.

    I don't expect people to feel sorry for me but just understand why I don't do more.

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  • predecessors were good teachers.
    Young new gps are good students.
    Nothing is more precious than seeing your kids growing up and seeing your parents getting old.
    No OBE no helicopters in our profession why die young by taking extra stress and by paying extra indeminity insurence. No business class no five stars in our life, why die young by doing free charity work.

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  • Does it really matter if the next generation have different values than the one that went before it? Yes we all know (they keep reminding us) that the baby boomers worked hard. The ones I know also own massive houses, dive Audis and sent their kids to private school. They weren't being persecuted and prosecuted after seeing 40 patients with 40 different diseases in a day.

    Things change. The next generation having been priced out of nice housing whilst graduating with £100K debts have realised that quality of life matters and you won't get the time back to watch your kids grow up. Is that really so bad?

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  • The job is extremely difficult now and the pay after tax and superannuation is derisory. And yes Mr Cumming - the millleninals and Generation Y are not fooled and quite rightly are voting with their feet.

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  • Vinci Ho

    First , they branded us , the older ones , f***ing lazy . Now it is our youngsters' turn.
    Gosh , we really have a common enemy

    'In our society , those with the best knowledge of what is happening are also those who are furthest from seeing the world as it is. '
    1984 , George Orwell

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  • The less than good prof fails to consider the demographic changes which have altered the intensity of the work.But this non-medical doctor, whose flatulent spoutings offend the nose and the sensibilities, is a pen-pushing arse who has risen to the dizzy heights of management. A tier which is more often than not occupied by the incompetents who lack the gumption/skills/aptitude to do the kind of job we GPs do.

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  • I (millennial, full time) see typically 160 standard appointments, 25 emergency face to face appointments, 25 telephone appointments, 20 further emergency telephone appointments and 16 home visits in a week.

    I would like to know how that compares to a GP in 1987? I suspect it is not less.

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  • Are they trying to work out why the 'milenials' don't want to work the longer hours? What an absolute load of crap! It's not just the younger doctors who are cutting their hours. It's everyone, and the older doctors are passing the time until they can retire. Why don't you ask yourself why GPs are reducing their hours and cutting their pay? It's because the job has become impossible and we cut our hours to just survive. What complete and utter ignorance!!

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  • The more you work the more tax you pay.The way the NHS is going noone wants to carry the workload .more litigation. Patients are more demanding these days.They think GP has a magic wand and cure all the problems.

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  • Thanks Prof for that great insight. How many sessions did it take you to pontificate and develop such a helpful and constructive opinion? Fortunately you have taken the hard route into educational academia to get away from all those lazy family and life loving GPs. On behalf of GPs I thank you for your sacrifice that has certainly improved my understanding of GP workforce issues today.

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  • This non doctor is nothing more than a high priest of the spreadsheets, high flyer amongst those who generate reams of data whilst remaining blind to true knowledge.

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  • Now retired and wouldnt return under any circumstance. Its not the money its not the time its the unsafe relentless demand

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  • Seriously, what planet is this guy on?
    If he thinks that it is only millennials that are working fewer hours (but work intensity has mushroomed!) then he is naive.
    Back to the old attitude "in my day we worked 120 hour weeks and were grateful".
    Unhelpful and just plain wrong!

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  • Just Your Average Joe

    Patient demand and expectations.

    Pointless complaints - driven by cost cutting and services not available due to CCG austerity drives - and being hung out to dry.

    Ridiculous indemnity costs where working more especially OOH is cost negative once punitive tax rates kick in - so that you need a hole in the head to work more - Make all indemnity free as a starting point

    New Junior doctor training hours reduced to 40 hours - why work more once qualified? By making them work normal hours - the DOH has driven out the previous generations ability to cope with 100hr weeks, so the day job of a full time GP is too hard/stressful.

    Ramming CCG, federation and other non essential roles into the day means less hours to do core GP work.

    CQC and revalidation requirements.

    Picking up work unfunded and shoved out from Hospitals - takes time to do it.

    Increasing home visiting with complex elderly patients abandoned by hospitals into the community with inadequate care packages/provisions, needing lots of time.

    Don't shoot me! - however there is now a predominant female GP workforce with children - working part time to have a reasonable worklife/family balance - often working during just school term time and locuming.

    Increasing charges by PropCo and dropping of MPIG and PMS reviews.

    Need anyone go on!

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  • Ian Cumming clearly doesn't have any clue what working GP life is. I suppose the view of the ground is a bit blurred from way up in his Ivory Tower......muppet. I suggest we all regards his opinion with utter contempt and ignore all future diatribe that he may offer on any issue.

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  • I could work more hours but find that once MDO fees/tax/pension is factored in it is not worth it. IF they truly want primary care to survive then we need crown indemnity. Simple. just do it.

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  • its not the hours its the intensity, simple example, -i recall plenty of former 5 min appointments for dyspeptic sx- no,it isn't cardiac,regular script mist mag or gaviscon,next please...now its ppi plus followup to refer for endoscopy or breath tests with explanation,plus later followup to explain why they must wean off this wonderful ppi- so safer quality/higher intensive treatment for same symptom, but needs paying for!

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  • More work into fewer sessions
    The sessions are getting longer and longer as the hospitals dump more and more

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  • What is the proportion of newly qualified GPs who are female now? Of course a lot of them are going to work less than full time, dur!

    Quite apart from the fact that a "half time" GP (like me, and I am female, and have never worked "full time" since I qualified as a GP) works a 36 hour week. If I was "full time" that would be 72 hours and it just isn't possible to do.

    "full time" in many practices is now 8 sessions so you can have a whole day to do the admin stuff without having to generate new admin by seeing patients. Otherwise we would be there till 1am every day, instead of just 10pm. (and we close the doors at 6.30, this is not even extended hours).

    But at least they have recognised there is an issue and are now planning to at least try and train more GPs to fill the gaps...

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  • AlanAlmond

    I work part time and it's isn't because I'm 'millennial' cause I'm not. It's because if I worked full time it'd be a matter of months before I was struck off for screwing up or punching someone. This is the comment of someone who gets their 'information' secondhand without real understanding. An essential quality if you want any kind of role mismanaging the NHS.

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  • yes obviously the answer!!!

    so its nothing to do with gross underfunding,insane demand, and regular beatings from lawyers politicians ,steve field after all
    silly me

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  • Scrap MDO
    Need crowns indeminity
    Scrap revalidation and cqc
    Forceful retirement of nhs managers.

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  • more than 6 sessions a week is not sustainable long term with current working practices/load/demand/intensity. And it really isn't just female docs doing reduced sessions, most blokes I know have reduced hours in last 5 year also. Comes down to work life balance, slavery or freedom.

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  • Misery or happiness ?

    We choose. Slavery is not legal at the moment

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  • Ah the good old days -yes pre-CQC doctors spent more time seeing patients, less time covering their backs and doing meaningless risk assessments.

    Consultations were quicker, demand was less, work intensity much less. Doctors told patients what to do, and patients did it or got told off!

    Doctors work very long hours now and then. Yes we have more female workforce - so none of this is a suprise.

    Whats the solution- I agree crown indemnity /or better no-fault compensation such as New Zealand http://www.acc.co.nz/
    Far too much of NHS budget spent on litigation maybe 25%- much of this going to solicitors, not patients. If we could recoup £1Bn or 2 for GP -who knows what we could do with it.




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  • there are so many responses to so many similar articles but never a response from the person who made the comment reported in pulse-is this due to lack of editorial interest?

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