This site is intended for health professionals only

At the heart of general practice since 1960

Over two-thirds of GPs plan to leave or reduce hours, finds DH-backed study

Even 'desirable' areas of England are facing an 'impending healthcare crisis' as two in five GPs are planning to quit within five years, with researchers suggesting this has wider-reaching implications for workforce planning across the country.

The study, published today in the BMJ Open, also found that seven out of 10 GPs in the South West intend to change their working pattern to reduce patient contact in the next five years – either by leaving patient care, taking a career break or reducing their hours.

The University of Exeter researchers, whose work was funded by the Department of Health via the National Institute for Health Research, said that this 'snapshot of low morale' may point to a 'deeper and more imminent crisis than previously anticipated' with regard to GP shortages nationwide.

However, the Department of Health pointed out that the research, which included more than 2,000 GPs, was carried out last year, which could mean its GP Forward View £2.4bn rescue package for the profession may have moved things on.

Lead researcher Professor John Campbell, professor of general practice and primary care at the University of Exeter Medical School, said: 'We carried out this survey because of a nationally recognised crisis in the shortage of GPs across the country, and our findings show an even bleaker outlook than expected for GP cover, even in an area which is often considered desirable, and which has many rural communities.

'If GPs have similar intentions to leave or reduce their hours in other regions, as many are reporting, the country needs to take robust action more swiftly and urgently than previously thought.'

The research team sent surveys to 3,370 GPs across the South West, receiving responses from 2,248. Of these, more than half (54%) reported low morale, and this group was particularly likely to also say they were planning to quit the profession.

The researchers concluded that this highlighted 'the magnitude of the potential GP shortage crisis that is imminently facing the region, and reflect the current state of general practice in the UK'.

Professor Campbell, who is also a practising GP, suggested that the 'numerous Government-led initiatives' which are under way to address recruitment would not 'address the underlying serious malaise which is behind this data'.

He said: 'We are in a perilous situation in England, with poor morale of the current GP workforce, and major difficulties with recruitment and retention of GPs reflected in the stark overall reduction in the GP workforce. Reactive, sticking-plaster approaches are not the answer.'

GPC chair Dr Chaand Nagpaul told Pulse: 'Whist the Government has been focusing on 5,000 more GPs, these findings highlight a far greater scale of workforce reduction.

'The Government and NHS England need to focus on retaining doctors, not just looking at new recruits.'

The news comes after a UK-wide BMA survey of 16,000 GPs carried out two years ago found that 34% were thinking of retiring from the profession within five years. More than a quarter (28%) of respondents who currently worked full time said they were considering going down to part time.

Professor Helen Stokes-Lampard, RCGP chair, said she was 'confident' that last year's £2.4bn NHS England rescue package for general practice 'is that long-term solution', and that the RCGP is therefore calling for it to be 'implemented in full, swiftly and effectively'.

A DH spokesperson said: 'This sample survey was carried out before we launched our world-leading plan to improve conditions in general practice – so it doesn’t take into account our steps to improve morale and retention by investing £2.4 billion more into primary care, making extra payments to GPs, and cutting red tape while increasing flexible working.'

GP numbers in decline

The worrying conclusion to the research study were underlined by the latest GP workforce figures, revealed in March.

These showed that number of full-time-equivalent GPs dropped by 1.3% - or 445 GPs - in the last three months of 2016 alone.

The statistics, which also showed headcount falling by 0.9% (390) in the same time period, come despite Government efforts to grow the overall GP workforce by 5,000 by 2020.

This has included the '10-point plan' to boost recruitment and retention drawn up in January 2015, and comes despite HEE reporting a record number of doctors opting for GP training in 2016/17.

 

Readers' comments (30)

  • I already have reduced my hours by two sessions and I've haven't been a GP for three years. I don't want to be partime but 8 sessions of just seeing patients is too much. I can't see how I can do this for the next thirty years. And nothing is changing. The only way I can see doctors from not going partime to reduce workload. We need to ditch this obsession with 10 minute appointments

    Unsuitable or offensive? Report this comment

  • Flying back to Australia shortly......

    Unsuitable or offensive? Report this comment

  • Already left

    Unsuitable or offensive? Report this comment

  • Been there 2 years and not looking back.

    Unsuitable or offensive? Report this comment

  • This is pretty much in line with the research we did in the West Midlands last year showing 42% looking to leave. https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-015-0363-1

    Unsuitable or offensive? Report this comment

  • Cobblers

    DoH "This sample survey was carried out before we launched our world-leading plan....."

    Hahahahahaha! Tears of mirth. World-leading. Yeh right. I can see the rest of the world following, not.

    DoH world class pseudobabble.

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    A DH spokesperson said: 'This sample survey was carried out before we launched our world-leading plan to improve conditions in general practice – so it doesn’t take into account our steps to improve morale and retention by investing £2.4 billion more into primary care, making extra payments to GPs, and cutting red tape while increasing flexible working.'

    Ha ha ha haha
    Typical Ministry of Truth.
    Incredibly arrogant , lugubriously out of touch ,obsequiously technocratic . Dare not even give a name other than 'spokesperson'.
    Ladies and gentlemen, do we all know what ' insulting intelligence' means ?

    Unsuitable or offensive? Report this comment

  • "However, the Department of Health pointed out that the research, which included more than 2,000 GPs, was carried out last year, which could mean its GP Forward View £2.4bn rescue package for the profession may have moved things on." King Canute comes to mind.

    Unsuitable or offensive? Report this comment

  • No grass root GPs like the present position as a GP, nor the five year future model of general practice slavery. That is reflected in the survey.

    The only reason that some LMC reps, GPs sitting on CCG boards, GPs leading federations and the hierarchy at RCGP like the future model is because they think that they will be able to cream off some of the new dosh before it reaches the grass roots. And sadly they are probably right. Money sticks to those closest to it. Just look at the financial sector for proof.

    Unsuitable or offensive? Report this comment

  • Working at Scale - that's the answer. To everything.
    Cures all forms of health resource woes, warts, piles and all. Just wait and see. We just need to stop being Luddites and listen to the eminent guy in the ermine clobber wielding a Cuscoes in his spare time. I don't know what we're droning on about. £100k+ pa for a four day week of sitting, just chatting to people and writing letters to fob them off to the really clever doctors at the hospital. Golf, private schooling, public respect, loads of job satisfaction. What's the problem?

    Unsuitable or offensive? Report this comment

  • The Department of Health statement exactly demonstrates all that is wrong with GP. They absolutely refuse to admit that their is any problem and if there is (never taking responsibility for creating it in the first place) then it is about to be fixed. But it never is. We all know that the £2.4 billion "rescue plan" will get watered down, disappear into secondary care and the final dribble to reach us will be so hedged about with impossible conditions as to make it impossible to achieve.
    The DH needs to say we got it wrong, you have been massively underfunded, here is the shortfall from yesteryear and here is the extra money going forward and look here it is in your bank account.

    Dream on.

    Unsuitable or offensive? Report this comment

  • Lack of accountability, dysfunctionality, politically motivated masters are completely out of their depth.

    Unsuitable or offensive? Report this comment

  • I retired 2 years ago when aged 60. My partner who replaced me as senior partner has just retired at 57. My former junior partner is now senior partner and already has had enough at 53 with the intention of retiring at 55. I feel sorry for the new partners in their early 30s who will be left at the coal face.

    Unsuitable or offensive? Report this comment

  • i retired and just do 4 surgeries a week. i am very happy apart from cost of indemnity.

    Unsuitable or offensive? Report this comment

  • 'A DH spokesperson said: 'This sample survey was carried out before we launched our world-leading plan to improve conditions in general practice'

    Well, since this sample survey was carried out, my last 3 remaining partners have all resigned from the practice, leaving me as the last man standing. Thanks DH - I shall look forward to your world-leading funding making a big difference. Better make it quick though.

    Unsuitable or offensive? Report this comment

  • A large wad of cash will fix this ala 2004. The NHSE knows this . But it does't want to fix it . We all know what is about to happen. If you possibly can -jump now . Any later and you will be killed in the implosion.
    There will be no rescue because it's already too late .

    Unsuitable or offensive? Report this comment

  • Work is a chore not a vocation I choose!I have called it a day after23years as my health suffered and demand has increased year by year and financial cuts have worsened!.

    Unsuitable or offensive? Report this comment

  • AlanAlmond

    The truth doesn't stop being the truth just because you regularly feed the newspapers with crap from a big government propaganda and bullshit department. It's a dangerous and stupid way of running a National Health Service. The guaranteed result is that solvable problems are ignored as HMS NHS steams full speed ahead into an obvious looming ice burg. As the ship goes down those at the wheel are busy congratulating themselves on a wonderful choice of wallpaper in the public relations room on the first deck.

    Unsuitable or offensive? Report this comment

  • Last year I reduced a session, this April I am seeing patients from 9 am instead of 8amand doing a 3 hour session instead of 4. Why - main reason - I took on 1000 patients but my local NHSE bosses decided to reduce my weighted list successively and only 400 of the new patients are paid for. My MPIG was reduced by 25k when they learnt he was taking me as a partner. I understand the privilege of being the only GP in UK to have an MPIG cut at a time when this was untouchable.
    My sympathy is with patients and my apologies too as I can't cope as I did. Time to pack up and even leave the country where you are treated as shit.

    Unsuitable or offensive? Report this comment

  • This comment has been moderated

  • The MPIG cut came in 2010.

    Unsuitable or offensive? Report this comment

  • These are in many ways manifestations of burnout due to excessive workload, complexity, multimorbidity, constantly 'giving' and lack of support services compounded by fear of complaints and defensive practice

    Given all this, we should be very proud of how much we are achieving and delivering

    But Somehow we must find a way forward
    as this is not sustainable

    How can we 'keep general practice brilliant'*

    I was very impressed with the RCP project on *keeping medicine brilliant'

    Here an evidence base was defined was action including Eight ‘domains’ of a doctor’s working life

    Workload
    Physical environment needed for work
    Interpersonal relations in the workplace
    Hospital administration and policies (read practice)
    Personal characteristics
    Career, education and training
    External/home circumstances
    Patient safety

    There is no magic bullet but I believe there are opportunities so we can use our initiative to improve morale and wellbeing in a holistic way

    stronger national and local strategies and actions are needed

    Unsuitable or offensive? Report this comment

  • Could we for example develop measures by which general practice can sensible control/limit its workload

    with an overflow to hubs

    Unsuitable or offensive? Report this comment

  • Somehow, it does not sound weird getting bubbling enthusiasm from CCG and LMC enthusiasts.

    Unsuitable or offensive? Report this comment

  • These lmc and ccgs are government puppets.why will they go against the government?

    Unsuitable or offensive? Report this comment

  • Already cut 2 sessions and added admin time and meeting time to what's left. CQC, answering complaints, Appraisal shit and other nonsense comes first, obviously. Think, I can last another 20 years. The most important thing is, each time some genius comes up with another brilliant idea ( like some above)- I shall look at how much time and resources it will take ME, and cut patient time accordingly. any other approach is irresponsible as puts you at risk of burnout. Ok, its 4 weeks wait to see me now. Carry on adding your stupid ideas into my work and life and we all know which way waiting times will go.

    Unsuitable or offensive? Report this comment

  • doctordog.

    reached max pension pot so reduced by 2 sessions per week to reduce tax liability.
    If the silly tax thresholds were more favourable, would not have done this.

    Unsuitable or offensive? Report this comment

  • I have yet to see ANY, that is ANY, evidence of any GP forward view cash. Where is it??

    Unsuitable or offensive? Report this comment

  • A DH spokesperson said: 'This sample survey was carried out before we launched our world-leading plan to improve conditions in general practice – so it doesn’t take into account our steps to improve morale and retention by investing £2.4 billion more into primary care, making extra payments to GPs, and cutting red tape while increasing flexible working.'

    The sad thing is, I really think they believe this is true

    Unsuitable or offensive? Report this comment

  • Nothing will improve until politicians have the courage to tell the public the NHS is for their needs and not their wants.Unfortunately "evil Tory plot" gets in the way of any attempts at reform.Why can we not have a cross-party consensus that acknowledges the current construct is broken, and that we should regard the NHS as a means to and end (a defined provision of healthcare)and not an end in itself? Sacred cows should be slaughtered!

    Unsuitable or offensive? Report this comment

  • Agree with all of the above
    The issue is not about money
    It is about morale
    Morale is not bought by money in caring industries
    Look to some charities that do unimaginably amazing work on minimal budget...

    Morale is bought by shifting the environment in which we work
    Compassionate environments rely on some core elements
    Which include
    Sympathetic
    Motivating
    Sensitive
    Non judgemental
    Empathic
    Supportive of those in distress
    - building distress capability and tolerance

    An environmental change using these elements may not require as much remuneration ....

    very little of the above exists so you have a profession that feels of little value and with diminishing morale..
    Why are we surprised?
    Time to wake up

    Unsuitable or offensive? Report this comment

Have your say