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GPs go forth

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)

  • 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

    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

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

    with an overflow to hubs

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

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

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  • 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.

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  • 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.

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

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  • 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

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  • 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!

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  • 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
    Non judgemental
    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

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