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90% of GP trainees to shun full-time clinical work

Only one in ten GP trainees expect to be doing full-time clinical work in five years’ time, a major report from the King’s Fund think-tank has revealed.

The report – Understanding pressures in general practice – also claims that the crisis in general practice has been ‘invisible’ for policy-makers due to failure by the DH and NHS England to collect data.

Its analysis of 30 million patient contacts from 177 practices found that the number of consultations since 2010/11 had grown by 15%, echoing a recent study published in the Lancet.

GP leaders said that the lack of data on general practice had led ‘many to turn a blind eye to the ever-worsening crisis’ in the profession.

The report comes two weeks after NHS England released its ‘General Practice Forward View’, which committed to devoting more than 10% of the NHS budget into general practice.

The King’s Fund welcomed NHS England’s proposed measures, but warned that general practice was in a crisis.

It pointed to an increase in demand and a reduction in funding, as well as a recruitment crisis.

And it warned that the recruitment crisis could get worse, as a survey of 318 trainees revealed they were shunning a full-time career in general practice – and not only because of family commitments.

It said: ‘One of the most striking findings from our survey of GP trainees was that only 11% intended to pursue full-time clinical work in general practice five years after qualifying.

‘The key reason cited for not intending to pursue full-time clinical work was the intensity of the working day (22%). This was followed by family commitments (19%), long working hours (17%), volume of administrative work (14%), work-related stress (%) and interest in other work (10%).’

The think-tank also found there was a lessening appetite for partnerships, with less than half expressing an interest being a partner in ten years’ time.

The report also revealed:

  • Consultations grew by more than 15% between 2010/11 and 2014/15.
  • The number of face-to-face consultations grew by 13% and telephone consultations by 63%.
  • Over the same period, the GP workforce grew by 4.75% and the practice nurse workforce by 2.85%.
  • Funding for primary care as a share of the NHS overall budget fell every year in our five-year study period, from 8.3% to just over 7.9%.

It concluded: ‘The Department of Health and NHS England have failed over a number of years to collect data that would have provided advance warning of the crisis now facing general practice. Action is urgently needed to reverse reductions in funding as a share of the NHS budget and to recruit and retain the workforce needed to meet rising patient demands.’

It comes after a study in the Lancet concluded general practice is reaching ‘saturation point’, with patients seeing GPs more often and for longer while GP numbers fail to increase, while offical figures last week revealed GP numbers decreased by 2% last year.

Dr Maureen Baker, chair of the RCGP, said the GP Forward View was an ‘acknowledgement of the devastating impact of a decade of chronic underfunding for general practice’.

She added: ‘But we should never have reached this point – the lack of national-level data on the state of general practice in recent years enabled many to turn a blind eye to the ever-worsening crisis until our profession was on the brink.’

An NHS England spokesperson said: ’The General Practice Forward View published a fortnight ago tackles head on the rising pressures in primary care, backed by a ground-breaking £2.4bn action plan. At the same time the most comprehensive data on rising GP workload has just been published in The Lancet drawing on work commissioned by NHS England from Oxford University.’

A DH spokesperson said: ’With an ageing population, we know GPs are seeing more patients with complex health conditions than ever before. That is why we are taking action to double the growth rate in GPs through new incentives for training, recruitment, retention and return to practice.

‘NHS England’s GP Forward View, which commits an extra £2.4 billion for general practice by 2020/21, will help to reduce the pressure on GPs and retain a healthy workforce well into the future.’


Readers' comments (23)

  • And the Telegraph is reporting today that there are recommendations to send volunteers into GP surgeries to help with the manning crisis. Who are these volunteers?

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  • Hardly surprising. Full time clinical work is neither, financially, spiritually or emotionally rewarding and after 5 years fatigue and burn out is inevitable. Most sensible people will either locum full time or part salary part locum early in their career. Also what about pursuing other interests, teaching, research, federation, CCG all that other stuff we are supposed to do how does that fit in to a full time clinical working week?

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  • Describing it as 'full time' is really not that accurate. In our large surgery we have 4 part time/ 5 session doctors who all work over 37 hours/ week - so really are full time.

    Our 8 session partners are about 70h/ week so should be described as double time.

    90% of junior doctors not wanting to work double-time is probably a more accurate statement.

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  • Or it could be that you can earn £4250/wk as a locum, not do the soul-crushing crap that partners do, not take the personal liability and get home in time to put the kids to bed. Sounds like a no-brainer to me.

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  • 08:30 are we in the same surgery, sounds very familiar? 70 hours a week is killing me, but you have forgotten that we also spend days off wiped out plugging crap into Clarity

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  • yet again though no real info on the 2.4billion actually coming into GP practices only that it is coming to Gp practice which is anything to do with primary care rather than GP practices so talking therapires etc but not to help us day to day jobbing Gps,
    Also the Elephant in the room is the fact that medical schools are 70 % female as the girls do better at school and hence rightly so get medical school plaaces but they usually work part time so as to bring up a family which again is the right thing to do. Unfortunately this however dilutes the workforce by 50%. how we get around this is not easy but med schools need to think of a better way of selection rather than just on grades as we also know that the cleverest in society don't always make the best Doctors !

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  • Also not enough working class males coming through who need to work full time. Most of my registrars are married to high flyers and will work 2 sessions or so if that. The registrar training does not help with 7 clinical sessions max. and lots of protected time which they get used to quickly.

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  • I work full-time. Not only the clinical stresses take their toll but running a practice-all the staff issues. And dealing with all the endless problems.
    I have children and a mortgage-so comply with this "miserable existence" for the sake of my children (like many other non-doctors I am sure) but who would volunteer for this if they thought they could lead another life???

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  • The report (all 100 pages of it) seems pretty good - worth downloading and having a quick scan through.

    It documents the multiple stress that all GPs now face every day and the grim outlook that primary care faces (unless a whole series of unlikely miracles occur).

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  • What is so annoying about this is that they have been told endlessly for years that primary care was cracking up but just chose to ignore it. There seems to be absolutely no accountability.

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