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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)

  • I left aged 43, after many years as a partner. I don't even think burnout or fear of it was an important factor. It was just boring and miserable. Pay and workload were actually OK but the idea of dealing with the monotony and the daily unplesantness/aggression/demands from patients (albeit a minority, but a minority who attended very frequently) was unpalatable.

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  • I am 43 and ready to leave NHS practice. If 2016 is any worse than 2015 with respect to pay or working conditions it will have exceeded the pint where this job is worth it. Locum or private practice would be my options as leaving the country is not viable due to family.

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  • Re criticism above of a previous post "Balint groups and resilience training should cure a lot of these naysayers."

    It's called sarcasm.

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  • Prediction:
    More gp burnout due to 7 day.
    More exodus of gp.
    More strain on existing working gp.
    More increase in over 60 elderly with multiple health problems, needing more time and more unhappy patient as they want to see the gp on same with a couch and cold which started in morning.
    More pay cut to GP.
    Unsustainable NHS, trial with privatisation.
    The whole process will take another 10 years.
    Good luck NHS, will not waste my valuable years of my life in anticipation that situation will improve.

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  • http://tinyurl.com/zfdnfls

    GP headcount DID increase by 5729 between 2004 and 2014. But between 2009 and 2014 headcount increased by only 315 (

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  • I'm 44, and the day before this article was having meetings seeking advice and considering what to do instead of GP.
    I want out asap.

    I've been a partner, locum, salaried, OOH GP over last 15 years.
    Can I cope with another 20 before retirement? No

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  • GPS over 50 too burnt out to organise getting out :(

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  • I really hope we see some changes soon.
    I have given myself 2 years, and will re-assess then.
    Am on maternity leave during that time (6 months) from April. I am currently deciding whether I spend some of that time re-evaluating career options; or investing time in exploring re-structure options for my practice/working at scale etc.
    The next few months will be critical for me. General practice is all I have ever wanted to do, and I feel sad and disappointed at what it has become. Many of my GP friends are planning exit strategies; positive change and solutions must come our way soon. Hoping the BMA LMCs Special Conference will lead that....

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  • government et al are an issue, but not the main problem driving GPs away. sorry, but it must be said. the PATIENTS are the problem.

    as others have mentioned, every consultation is a potential source of complaint/litigation. We have to battle with people to get them to accept treatments just so they don't sue us claiming we didn't following NICE guidelines when they become more ill later on, forcing us to see them for all of life's tiny ills and complaining when we can't help them, refusing to take any responsibility for their own problems (especially non medical ones), and dumping everything and all their problems on us and expecting us to wave our magic wands to fix their woes even though they know full well we can't do anything about it. And on top of this, expecting us to travel all around the country doing home visits for perfectly able-bodied 20 somethings who would rather spend their money on fags than a taxi to see us when they become unwell, and dumping their elderly grand parents on us and expecting us to babysit them overnight because they 'can't stay'

    there, said what we all were thinking.

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  • @|Anonymous | Sessional/Locum GP|14 Jan 2016 1:07pm
    I agree that a minority of patients generate a very large amount of work and cause problems. I however think that the blame is not all on them. We allowed them to make as many appointments as they wanted and for whatever trivial issue they percieved. Patient education is part of our job but unfortunately fear of complaints and litigation has taken that away from us. The GMC and politicians created this environment and patients simply took the easy option. Lets not resent the patient hard as it is.

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