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Independents' Day

Over one third of GPs 'may retire' within five years, warns BMA

The largest-ever GP survey has revealed stark figures threatening retention within the profession, including over one third considering retiring altogether.

Releasing the second part to its survey of nearly 16,000 grassroots GPs, the BMA said 34% were thinking of retiring from the GP profession in the next five years.

Also concerning, over one quarter (28%) of respondents who currently worked full time said they were considering going down to part time.

This came as 16% of all survey respondents said that their stress levels were ‘significant and unmanageable’.

Conducted by ICM Unlimited for the BMA, the major survey also saw less than half of GPs (47%) would recommend general practice as a career, although at 53% Scottish GPs were slightly more likely to do so than in Wales (at 48%), England and Northern Ireland (both at 45%).

The results also delivered a warning on retention among the youngest GPs entering the profession, as one in five GP trainees said they are considering leaving the UK to work abroad over the next five-year period.

The GPC said that the ‘incredible pressures’ on GP services were to blame for this crisis of the workforce.

GPC chair Dr Chaand Nagpaul said: ‘This poll lays bare the stark reality of the crisis facing the GP workforce. A third of GPs are considering leaving the health service in the next five years and a significant number are also thinking about reducing their working hours. It is clear that incredible pressures on GP services are at the heart of this problem, with escalating demand having far outstripped capacity.

‘GPs are overworked and intensely frustrated that they do not have enough time to spend with their patients, especially the increasing numbers of older people with multiple and complex problems who need specialised care.’

When asked what impacts most negatively on their commitment to the profession, 71% said excessive workload. The next most common answers concerned unresourced work being moved into general practice (54%) and not being able to spend enough time with patients (43%).

Dr Nagpaul said: ‘In this climate it is absurd that in the recent leaders’ debate, political parties were attempting to outbid each other on the number of GPs they could magically produce in the next Parliament. Since it takes five to eight years to train a GP it is not possible to create thousands of GPs in this time frame. It is deeply worrying that a fifth of GP trainees, the GPs of the future, are hoping to move abroad before 2020.

Last week, the first part to the BMA’s GP survey revealed that nine out of ten GPs think the ten-minute consultation standard is inadequate for patient care, with GPC calling on politicians to rethink party pledges focusing on the speediest access to appointments.

 

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Readers' comments (38)

  • consider the following;

    1. seven day working 12 hours a day
    2. 48 hour access
    3. same day access for over 75'
    4. named GP for every patient
    5. movement of secondary care services to primary care
    6. end of independent practice
    7. salaried profession i.e. controlled
    8. increasing demands by Quangos moving goalposts at will
    9. GMC willing to take an even harder line, multiple jeopardy etc
    10. drive to reduce referrals and prescribing in the face of litigation for the slightest mistake.
    11. more and more demand etc etc etc

    The point is - if you think things are bad now - you ain't seen nothing yet and when things start to get worse that 'one third' may change to 50% then 70%...

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  • People who retire early are those who can afford to retire early.

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  • This should be front page holding news in all media. GPs have and are being victimised in a despicable way.

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  • Una Coales. Retired NHS GP.

    On Inside Harley Street, Professor Roger Kirby shared that he had worked for the NHS for 25 years before he left (and is now solely private). He called it serving longer than a prison life sentence.

    When I retired this year, after my 19-year NHS life sentence, it was a relief and a breath of fresh air. No more stressing over pointless appraisal and revalidation paperwork, listening to an East European patient threaten me with a lawsuit if I did not refer them to the specialist for a minor condition, answering a young EU patient's question on what can I get for free on the NHS, replying to malicious GMC complaints from institutions and receiving no apology when cleared, etc. I should have realised what socialist medicine was when many years ago after a long weekend on call from Friday 8 am to Monday, instead of being praised for covering an entire ENT hospital service with intake from 5 hospitals, I was scolded because I did not cover an extra ENT clinic that Monday afternoon (not in my rota). I explained I was exhausted and went home instead to my 3 young children who had only seen their mother for 1 hour over 3 days. I wrote the consultant a 4 page letter of what I had done during that horrendous on call going on a few hours of sleep on a 77 hour straight shift and knew by standing up for myself, I had committed ENT career suicide.

    Well I applaud all the GPs who have emigrated, gone private or retired early. Time to wake up and stand up to abuse and exploitation because the longer you stay in the NHS, the worse it will get!

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  • "People who retire early are those who can afford to retire early"

    Wrong!

    I retired at 54 and have no income whatsoever. I am relying on my husband to earn enough to support me and we have cut down on living expenses to cope. As a younger GP I received no maternity leave, no sick pay or paid annual leave and, importantly, no pension contributions. my pension will not be great as it is based on only 20 years and includes part time working.

    You have choices.... and they include retraining to do something entirely different if that is better. My choice was that a healthy and happy life was more important than money.

    If you are at the start of your career, do something else. DO NOT choose general practice and expect it to get better. If you are in the middle of your career, consider stepping sideways into occupational health, another speciality or emigrating.

    You are highly skilled and intelligent people who have choices and should look after your own interests. Blind and ignorant ( unfounded) jealousy of other people will not help.

    We are all being shafted and I for one can't wait for the day that the government wake up to what they have done.

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  • @1:45- I agree with 6:26- I'm 54 and not planning retirement because I can afford it. Because I can't as 6:26.
    It's a choice you have to make. There is a whole Healthcare and Research industry out there and opportunities galore. If you don't want that then there is scope in Academics or always the opportunity to locum.
    If you want to take back control of your life and not let unscrupulous people associated with quangos and politicians manipulate you- then retire.

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  • Took Early Retirement

    Over 1/3 of GPs "may retire" is not really news, is it? It is a bit like saying, "The Tooth Fairy may come". We know it won't be like that.

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  • Vinci Ho

    Sad but true. The 'love' is over for many of us. Remember this song:

    "What Have I Done To Deserve This?"

    You always wanted a lover
    I only wanted a job
    I've always worked for my living
    How am I gonna get through?
    How am I gonna get through?

    I come here looking for money
    (Got to have it)
    And end up living with love, oh, oh
    Now you left me with nothing
    (Can't take it)
    How am I gonna get through?
    How am I gonna get through?

    You always wanted me to be something I wasn't
    You always wanted too much, oh, oh
    Now I can do what I want to - forever
    How am I gonna get through?
    How am I gonna get through?

    At night, the people come and go
    They talk too fast, and walk too slow
    Chasing time from hour to hour
    I pour the drinks and crush the flowers
    What have I, what have I done to deserve this?
    What have I, what have I, what have I done to deserve this?
    What have I, what have I, what have I ...
    We don't have to fall apart, we don't have to fight
    We don't need to go to hell and back every night
    We could make a deal

    What have I done to deserve this?

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  • 8-8 7 day week will see even more rushing for the exits..........

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  • At least the powers that beand the public cant complain they have not been warned of the pending irreversible collapse of primary care.

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  • I am beginning to think that the BMA and RCGP have some unwritten obligation not to get involved with General Election politics. If this is so, surely this is the time to smash this barrier and refute all these fatuous manifesto promises. The MPs who are medically qualified are deplorably silent at this time-I wonder why??

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  • Alarmist headlines.Thinking of retiring is not the same as actually doing it.The vast majority of those who are retiring would have retired anyway (the "48hr" pensioners).You need money to push your kids through private schools and maintain your lifestyle.That alone will keep alot of GPs going to well into their sixties.

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  • Una Coales. Retired NHS GP.

    @9:43am as half of NHS GPs are female, the average age of a female GP leaving is 34 (NHSEng data), many female GPs are secondary income earners already working part time and are leaving as they can rely on their husband's income as the main breadwinner instead of burnout, GPs are leaving and cashing in their pensions as soon as possible, and Generation Y GPs are quitting medicine to change careers or emigrating, that leaves a small percentage of remaining GPs (female and male GP main breadwinners too young to cash their pensions and too tied down to the UK to emigrate) to tend to 64 million Brits. How long before they crack?

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  • Re 'May retire' Threats or promises?

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  • GPs dont have to retire,no partners no long term salaried jobs,no continuitiy.Increased costs to health care with more admissions+defensive medicine simples.

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  • Peter Swinyard

    The first comment in this string is an interesting perspective and, if anything, optimistic.
    There is now a presumption of guilt on all actions of GPs from referral to diagnosis to prescribing to consulting rates to hours of availability.
    Despite my fairly reasonable work ethic I am starting to find some aspects of the job just un-do-able if I wish to preserve some vestige of a work-life balance and be able to smile for the last patient of the day as much as for the first.
    It is not the patients' fault that we are feeling put-upon.
    Retention of experienced GPs seems unvalued by the present payment structure - seniority pay is a recognition of the value of wisdon about patient management which is gained from years of experience and not from doing an MRCGP examination.
    Resourcing of practices needs addressing - I have taken a 25% pay cut in the last 3 years - this doesn't make me feel like pressing on as now....

    So what are the positive things that we can do to make GP better and make it fun to work here again? I really would appreciate positive suggestions - not moans (you can do that on the Pulse blog) to chairman@family-doctor.org.uk

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  • Secure environments GP

    Large parts of our work have been "un-doable" for some time, we are simply deluding ourselves, soldiering on not shouting out !. Do we not have responsibility to alert NHS England, GMC, CQC, Medical Directors when we are being obstructed in overcoming organisational barriers to good medical practice? Impossible situation at times.

    Dr Margaret McCartney states quite rightly "GPs cannot safely see 40 or 50 patients a day, with two or three problems each, and not slip up. If the GMC can’t recognise this, we need a regulator that can." I know that needed saying but what difference will it make?

    How about taking action on the grounds of organisational barriers:
    1. Patient Unmet need becoming an inevitable consequence if unprecedented funding squeeze for years.
    3. More understanding about the environments from which complaints arise.
    4. A need to ensure that doctors have tailored support to help them overcome the challenges they face when difficult choices must be made about practice funding priorities.
    5. Crown Indemnity for GPs, we are no longer truly independent, now at the mercy of Govt dictats. We now need a full acknowledgement of genuine mitigating factors when things go wrong.

    Patients are suffering as the NHS is past "breaking point".

    I don't think what I've stated is scaremongering but reflects the realities and trends of where we are going.

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  • When I started in GP land in the 90s I saw my self going through to 65 in a thoroughly enjoyable well paid career and counted myself lucky that I'd worked my arse of at school, med school and then hospital 1:2s or 3s. Astounding that I should have thought that way for the first years of my career but the last 2 parliaments have destroyed general practice.
    We need more doctors for the increasing needs of the patients--it is that simple. Retainment is more important than recruitment.
    PS. Under 50 (just) will go by the end of the next parliamentry term unless they are willing to help us.

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  • why do i never read positive things about general practice?

    I LOVE IT ; i would consider myself a portfolio GP working in various roles from salaried post, OOH, emergency hospital roles and private work. The diversity is fantastic....and that is why i chose this career. Not many of my friends have the luxury of such a rewarding job.

    The finances are fair, i work hard at being a good doctor and spend 90%+ doing medicine - NOT beurocratic nonsense such as QOF/DES/LES box ticking.

    The problem is being a GP Partner.....now that is not an enviable position...you wont catch me being sucked into that nonsense....working harder and harder ticking boxes, loosing site of the patient and resultantly taking pay cuts year on year!

    I would definatly be thinking of retiring or emigrating if i was in that position

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  • Secure environments GP

    12.01pm - That's exactly the point and why partners are retiring early. I "love" my portfolio work other half of the week. Keeps me going.

    But Locums and portfolio GPs can't prop up NHS primary care. Too much fragmented care and lack of continuity escalates costs (admissions and safety net referrals) since the "clinical risk equation" changes.

    Clinical and organisational governance is crucial to effective teams serving patients best interest as far as possible. If the partnership model viability has eroded so much, will the alternative be better for patients or more cost effective? NO.

    Solutions on postcard, with a picture of The Gold Coast Australia on the font...

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  • Most doctors (male as well as females) now entering the profession no longer work five days per week - there is a good reason for this - including pressure of work - political interference - and work life balance sits firmly in third place - and constant Daily mail constantly driving up demand, whilst being hell bent on demoralising the profession

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  • Female GPs are a 'good catch' for wives. Who would not want to marry to such an intelligent attractive caring woman? It is however likely that such eligible ladies will also marry well and be able to move on to better things when the expectations of general practice become unrealistic.

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  • Maybe some of us who are male partners would also fancy an escape from the cesspit that is general practice. I think all GPs (male and female) need to think laterally about GP as a career.
    Working as a slave partner or salaried GP is really not the way forward... perhaps locum chambers are the partnerships of the future!

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  • @above
    Don't worry.The future of General Practice is salaried and that's official.

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  • Una Coales. Retired NHS GP.

    Just got a request from an ex NHS GP in Alberta looking for a GP to join his small practice. Expected pay $450k-$650k. That's £245k-£355k! Looks like Canada will be attracting more GPs than Australia at this rate. Anyone wanting to join him let me know and I can pass on his contact details. He studied medicine at Cambridge. Seems like he is the smartest of us all, practicing clinical medicine, consultations up to 30 mins long and being paid well too!

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  • crisis? what crisis??
    "there's never been a better time to be a GP" according to a "leader of the profession"

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  • There's not much sympathy out there for GPs.The general feeling amongst the public is that if they can afford to retire early then they must all be overpaid to begin with.Besides,when the full time equivalent number of GPs have actually risen since 2013, shouting crisis is a bit like crying wolf.The powers to be don't believe it.

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  • we are all playing a game of chicken,as a nation if and when it does goe t*ts up and there is a crisis pray that it can be repaired or the NHS is gone.

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  • I do not know how the government have blocked the real crisis being tracked on daily public media instead.
    But they have succeeded and won another silencing plot with bashing strong to the pole.

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  • GPC - whose problem is it to negotiate a proper Contract.
    Of course it is tragic, but who should set it right?I think this is your problem, Chand. If you cannot come up with solutions, you should resign. Why stay if you cannot fix the problems. Why do you not ballot the profession to look for another direction of travel, if you have no answers?

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  • I'm pretty sure that well over 1/3 of those working in CCG's with GPs playing at commissioning (and the dross of bullying managers - left when the capable ones jumped ship) would love to retire too, but most of those that were rich enough have already left with massive payouts!

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  • @Vinci Ho | GP Partner | 15 April 2015 8:07am
    in answer to your question "what have I done to deserve this" - you and GP representative organisations allowed your profession to be mugged into a position where it is carrying the can for a lack of funding on the back of a few thinking they would receive power and money from it. Sur[prise there isn't enough money in the system and you have willingly fell into picking up the work the government won't pay for anymore!

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  • I joined general practice 28 years ago in the days when taking on a partner obtained for the practice an extra allowance. This was good for the practice as there were more doctors to provide more time for patients. We provided all out of hours care and our patients hardly went to casualty. Now they are all going to casualty!! The government is striving to achieve this but it does need proper funding for practices!! The goods days for patients and doctors in general practice have gone. It is best for yound doctors to make a life for themselves elsewhere as it is at present not going to happen in english general practice. For myself I have been semi-retired for several years and my pension taken out. You have to make a life for yourself-nobody else will. I am sad how things have gone for a career at the beginning I really enjoyed and there was good patient experiences. All gone to pieces now.

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  • Strangely enough, there is enough money in the NHS pot. The Blair/Brown Government set up PFI initiatives, which "allowed" developers to build shiny new edifices for us all to work in. This was because the NHS couldn't afford the capital projects, because of land/build costs. How naive! We now pay approaching 20% ROI /annum to these thieves/fraudsters . That is guaranteed taxpayer money over 35 years or the expected life of the buildings. Many directors/CEO's of these companies are floating round Nassau harbour in their gin palaces now toasting the NHS. I'm out of here in 2 years, because the guilt trip I have been on over the past 28 years is over. It's taken a while, but I've now seen through how easily we have all been manipulated by politicians, media and managers. Now is THE time to grow a pair and vote with our feet!

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  • @ Una coales
    I am one of these young GPs looking to move to Alberta. I have seen your post about this Alberta offer. Just wondered if you would be able to forward some more details about the practice and contact detaills. Could you please email me to nagaruru@ymail.com
    Many thanks

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  • Una Coales. Retired NHS GP.

    @12:33 pm, the GP vacancy in Alberta for $450k-$650k has been provisionally filled. It went incredibly fast! When NHS GP surgeries cannot fill a GP vacancy for over a year, it may have something to do with the pay being offered and NHS working conditions?

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  • 55 now and going soon

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  • "Anonymous | GP Partner | 16 April 2015 9:42am
    ....Besides,when the full time equivalent number of GPs have actually risen since 2013, shouting crisis is a bit like crying wolf.The powers to be don't believe it."
    It is meaningless to quote figures suggesting an increase in GP numbers without also quoting consultations per GP. This is going up fast...as work load increases. If you hadn't noticed the country's population has been growing, work is being shifted from hospital to the community, and people's expectations of what they should get from their Dr has been stoked up ...so what if GP numbers have increased a bit?...the population, it's consultation rate and the amount of extra work we are asked to do has gone up much much faster. Nobody is crying wolf...do you genuinely believe there is no problem??

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