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GPs under 50 leaving profession due to fear of burnout, NHS study finds

GPs under the age of 50 are abandoning UK general practice as they feel ‘unsupported and vulnerable to burnout’, an NHS England-commissioned study has concluded.

The study, published today in the British Journal of General Practice, found that personal reasons were rarely a factor for GPs relocating abroad, changing jobs or leaving on medical grounds.

The researchers concluded that ’to improve retention of young GPs, the pace of administrative change needs to be minimised and the time spent by GPs on work that is not face-to-face patient care reduced.’

It was funded by NHS England and Health Education England (HEE) to find out why so many GPs leave the NHS below the age of 50 years, which the paper said is ’contributing to the GP workforce crisis’.

NHS England and HEE developed their 10-point plan last year, which focused on incentivising GPs through ‘golden handshakes’, and video campaigns encouraging medical students about the virtues of general practice.

However, the study they commissioned surveyed GPs under the age of 50 who had left UK general practice.

The researchers from the University of Bath, University of Bristol and Staffordshire University highlighted that between 2009 and 2014, almost half (45.5%) of England’s GP leavers were aged under 50.

They concluded that deeper problems within general practice were the main factor to people leaving the profession, including:

  • organisational changes, such as the defunding of general practice, and more depersonalised and fragmented patient care;
  • a ‘values clash’, including impossible targets not centred on the patient;
  • increased workload, including more bureaucracy, management targets, regulations and guidelines, a shift of work from hospitals and increased patient demand;
  • negative media portrayal including political spin and being portrayed as ‘overpaid and under-delivering’;
  • and workplace issues such as partnership conflicts over workload and funding, less time for informal catch ups among colleagues, feeling more isolated in practice, a bullying culture, lack of occupational health support and Government expectations on GPs to do more with less funding.

The paper said: ‘Lack of time with patients has compromised the ability to practise more patient-centred care, and, with it, GPs’ sense of professional autonomy and values, resulting in diminished job satisfaction.

’In this context, the additional pressures of increased patient demand and the negative media portrayal left many feeling unsupported and vulnerable to burnout and ill health, and, ultimately, to the decision to leave general practice’.

It highlighted that the DH has continued to fail to increase GP training numbers to a target of 3,250 per annum, sticking instead at around 2,700.

Dr Tim Ballard, vice chair of the RCGP, said: ’The amount of red tape and bureaucracy that GPs and our teams are facing is overwhelming, and as this research shows, it is driving family doctors to leave our profession at a time when we should be doing everything possible to retain them.

’With more and more of our working hours being taken up with form-filling, ticking boxes and preparing for CQC practice inspections, we are drowning in red tape and this only serves to keep us away from delivering frontline patient care, which is why we become doctors in the first place.’

GP Survival media lead Dr Zoe Norris said: ’It is extremely useful to have confirmation in a peer-reviewed, well-recognised journal, of what grassroots GPs have been saying all along. That GPs want to get on with their jobs, we want to see patients.

’Any evidence that supports us in that fight against excessive bureaucracy in general practice, whereby we are essentially reduced to glorified administrative workers, is very welcome.

‘I hope that the Government takes heed, that they take it seriously. I very much look forward to hearing their response, which surely has to be that it will take an urgent and immediate look at the burden on general practice. This should be a wake-up call for the Government.’

An NHS England spokesperson said: ’Latest figures show there are over five thousand more full time equivalent GPs than ten years ago. GPs are key to transforming the way health services will be delivered in the future and this is why we are working hard across the health service to help GPs through the current pressures as well as investing £10 million in ways to further boost the workforce, including a campaign encouraging more medical students to become GPs.’

Pulse’s long-running Battling Burnout campaign has highlighted soaring rates of burnout amongst the profession, which helped lead to NHS England last year announcing a new national support service for all hard-pressed GPs to launch from this April.

Readers' comments (64)

  • Anyone surprised?

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  • Una Coales. Retired NHS GP.

    I left at 49 as rising medical indemnity costs, unpaid work for annual appraisals, looming pointless bureaucratic revalidation, NHS now becoming too high risk work, added up to financially not worth working 1-2 sessions as a part time locum GP.

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  • Dump Appraisal/revalidation.
    Dissolve the CQC.
    Two simple improvements that would cost nothing, but would save the NHS millions, free-up huge amounts of clinical time, and improve retention overnight.

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  • BJGP is hardly well recognised. More like the armpits of the world in terms of medical journals. I don't know a single GP who actually reads it.

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  • Don't expect the Beeb or red tops to trot this one out, despite the NHSE source. We must make this news.

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  • Music to Hunt's ears

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  • My GP father retired at 72,I retired at 60 (mainly to stop the government stealing my pension)but what I observed over 34 years, in contrast to my father's experience(in the same town)was the change in the attitudes of patients. The demands rose as the actual pathology diminished. The totally unrealistic expectations that GPs could solve all of life's problems; the medicalising of unhappiness, and latterly the refusal of patients to take any responsibility for inappropriate lifestyle choices(obesity, alcohol abuse etc).My greatest disappointment was the disappearance of the trust in the doctor-patient relationship meaning that every consultation was a potential source of complaint.Yes, there are many faults with the NHS as a construct, but unless the "customers" realise that they have responsibilities as well as rights, the exodus of highly motivated young doctors will only increase.

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  • The Daily Mail did not refer to this article!
    24/7 or extinction. Should this not be a newsworthy choice for patients and politicians.

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  • Una, I left at 48 last year for exactly the same reasons - despite getting through revalidation a couple of years ago. At first I doubted myself-not now. I know I made the right decision.
    I was a locum for many years as I could not bear the thought of all the admin, politics etc. I salute GP partners for the work they do. I knew my limitations and would have gone much sooner if I was forced down that route.
    I feel utter contempt for the GMC and those politicians who are game playing. However I also feel a significant proportion of the public have lost respect for the medical profession and view us as their servants. For those - they will get what they deserve when they have to get their wallets out....

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  • Unless all GPs working in the NHS, both in hours and out of hours are indemnified by the crown, within the next six months, I will be quitting General Practice. I can't continue paying ridiculous MDO's fees. I sincerely hope the BMA/GPC resolve this burning issue at their next meeting.

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