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Gold, incentives and meh

Why are so many GPs under 50 leaving the profession?

Researchers find overwork and burnout are major factors in the departure of younger GPs, reports Sofia Lind

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

The study, published in the British Journal of General Practice last month, found changes to the profession played a bigger part in GPs’ decision to leave than personal circumstances.

The researchers from the University of Bath, University of Bristol and Staffordshire University surveyed and interviewed 143 GPs under 50 who had left the profession, concluding 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 comes as Pulse’s long-running Battling Burnout campaign has highlighted soaring rates of burnout within the profession. The campaign contributed to NHS England’s decision last year to announce a new national support service for all hard-pressed GPs, which is expected to launch from April.

Dr Zoe Norris, media lead of pressure group GP Survival, 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.’

An NHS England spokesperson said it was ‘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’. 

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Readers' comments (34)

  • The question is, why should they stay?

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  • The answer is "because its shi@ and the UK is a cesspool"

    next question please

    Ditch the country comrades!

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  • I know that the state, media and public don't care (fair enough) but what are our representatives GPC/BMA and RCGP doing about it?

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  • Does anyone other than GP's even care right now? They will miss us when we are gone comrades.

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  • Vinci Ho

    An NHS England spokesperson said it was ‘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’.

    Seriously believing the Ministry of Plenty? Give us a break down of how you have spent the £10 million .....

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  • ... a turd on a silver platter garnished with all the trimmings is still a turd.

    Being a GP in the UK is an utterly miserable job and a very poor career choice. If you are under 50 and cannot emigrate it is fare better emotionally and financially to locum or explore private sector options. Funnily enough other professional sectors (including banking and finance) seem to rate a medical degree very highly. MB BS has a lot of professional capital for a medic wishing to switch to a new career.

    The private sector or occupational health are both rewarding options for NHS GPs wishing to switch. THe DoH may like to think that the over 35s and under 50s are stuck with NHS general practice but will probably find we have other options... shame but that's life.

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  • Not just the under 50s are going it's the just over 50s who are going. Had enough of this ridiciculous paperwork tick boxing chasing hospital stuff care plans that have limited value told not to refer told to refer more 2weekers etc etc
    51 next week and handed in my resignation and my work partner is doing the same. From 5 to 3 doctors.
    I do feel sorry for the remaining partners but my family tell me i haven't looked as happy as i do now. Time to be selfish for first time in my working career.

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  • Any young guns reading this just look at the above 2 posters.

    I left 3 years ago as well aged 31yrs. overworked underpaid and almost driven crazy.

    Emigration was the best decision I ever made. At last i enjoy my job again and have a life as well as a career.

    the people that run the NHS as well as those that purport to lead the profession dont care a damn about any of you. they dont care if you burn out, they dont care if youre overworked, they dont care if your health deteriorates......take it from me and the many before you this shite aint worth it, its time for you to make your exit plans and get out......

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  • Ex GP partner left 14/12 ago. My family had disappeared and and didn't even know until after I had left.
    What a waste of my life - just trying to get it back . 20 years of giving and who cares that I'm destroyed?
    The NHS is abusive to its staff and others in the system are co abusers.
    Get out now !

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  • All you students out there....7.22 is telling you straight! Listen and learn. It is a more important lesson than any you will learn at medical school.
    The powers that be just do not care one bit. They don't care about your life, your death, NOTHING!
    Leave now while you have the chance. Let them sort it out and you could always come back if things got better. But by that time you will probably be retired somewhere sunning yourself in Oz throwing prawns on the barbie!

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  • 9.16, I am sorry to hear about your life and others will be too. My life also could have been destroyed by the system, but I chose to appreciate the fact that I could not revalidate and now am really happy that I have escaped as I would not have done it by choice as I identified myself as a doctor and could not see life outside. Now I was effectively forced to go due to the regulations but am now happy to be a non doctor! No more GMC!!!!!!
    Good luck 9.16.

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  • To the doctors above who have left general practice, you will get no sympathy from me. Just a massive CONGRATULATIONS for releasing yourself from the shackles of a soul destroying impossible contract.
    Forget the delaying tactics of our so called leaders (many of them self-appointed, I am discovering by doing minimal research).
    The future is ours!

    Ditch the contract comrades!

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  • I'm leaving too.

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  • @ 9:54

    Ditching the contract doesnt make a shred of difference.

    Full time, part time, portfolio, locum, out of hours sessional, maternity cover...any form of work in the NHS is still working in the same soul destroying system within the same energy sapping infrastructure, a cog in the wheel of self destruction.

    being anywhere near the poisonous environment is nauseating and hazardous to ones sanity and physical health.

    there's something awful thats happened to the UK and its about to get much much worse.

    its time for people to face facts, the UK you grew up in is gone forever, just a distant memory and with a recession on the way, further health cuts arriving and an addled government with perhaps another decade in power the UK will resemble Chad in a decade or so......

    the country and the system is FUBAR!!

    DITCH THE COUNTRY COMRADES!!!!!

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  • Left for Oz few years ago. Was working in a reasonable area, but the ever increasing demands of patients with lists who would not be cut short, after going way-over their 10 min appt, combined with trying to cram in the QOF at the same time, made me realise that I couldn't go on in UK GP. Also too much abuse of the system - no self-care for minor illness, ripping off the DWP - and all for free! Life's much better now, and anyone who can make the move I'd encourage them.

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  • I'm getting fed up with seeing long gone to Oz gloaters or get rich quick locumers continually hogging the threads with their 'ditch this, ditch' that pronouncements. Well done, good for you - now move on. Let the grown folk speak about trying to save and revitalise a profession they have entered and wish to once again enjoy the job without having to resort to travelling 1/2 way across the world like a war refugee to seek gainful employment; nor become a locum because you believe seeing a patients once in their life for a buck constituents long-term job satisfaction.

    As the likes of Shaba and Una have said we need strong leadership to protect, no reclaim, what was once an enjoyable and rewarding profession. That is not being a cardigan, its about being proud of the efforts that you have put in in blood, sweat, tears and hours to become a doctor in the UK and refusing to accept that any government or media can belittle our worth and push us out of this country.

    Debate and argument from all sides are welcomed, but gloating is definitely not.

    DITCH YOUR GLOATING

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  • @1:50am

    You should consider a career in stand up comedy once the NHS collapses. You've got extraordinary powers of making people lose bladder control.

    As for Dr Coales, she was once of the trailblazers that convinced me to emigrate in the first place. If telling the truth is gloating then i make no apologies. In a forum like this its imperative one hears views from the whole of the spectrum and not just the so called "leader" who are regularly interviewed in their ivory towers and cashmere cardigans.

    we need people such as yourself to hold the fort while the rest of us plan our escape.

    Ditch your delusions!!

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  • Our "leaders"seem to be twitching the corpse that was once General Practice,pretending to fight back while going nowhere.Our profession is such a fragmented mess due to boomer self interest now that the only way to protest and or take control is have your own plans.There is NO ONE out there with the interests of the profession or the interest of the individual at heart.You after look after yourself,your own career and family.Is this failed arm of the profession worth saving?At the moment I seriously doubt it.

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  • @1.50

    I don't think it is gloating from people. I think they are still struggling with coming to terms with their career changes that makes them even look on pulse anymore.

    I say this as a partner in his late 30's who has recently resigned from my partnership and working his notice as it was becoming too much of a strain on my mental health and family life. I still feel bad about doing so, as though I have left my colleagues in the lurch.

    I left without a plan other than to look at locum work. I have thought about quitting medicine, but as with a lot of unhappy doctors I lack the imagination to think of a life outside of medicine having done it for so long.

    With a family committment moving abroad was not an option for me, and in no way do I look at locum as get rich quick scheme. To me when I start locuming it is about taking some control back

    It's pretty offensive to say let the grown ups discuss this and I think you should feel at least a little ashamed of that comment. People coming in and actually saying things can be better working in a different way is a support for many people who might be feeling right on the edge. People shouldn't feel the need to "cope" until they are broken, and unsupportive comments in such a way to colleagues is a part of the medical culture that we should be ashamed of.

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  • GP leaders have been too busy "saving the NHS", and volunteering our services as social workers and an "ideally placed" dump-box for everyone else's problems, to worry about saving General Practitioners.

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  • I an leaving - why!

    I can't stand Mr Hunt and his ideology.

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  • I am among those who have left and I am delighted that I did. How can you work with a GMC and a MPTS acting arbitrarily against doctors? I wonder why doctors do remain rather than to leave. From terror regimes the only defense is to escape or you'll be crushed. There is no possibility to save yourselves otherwise. Congratulations to those who remain. I wrote and published a book in order to preserve the safety of Italian colleagues: England: UK Unknown Kingdom.

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  • I have heard of people being let down by their friends but to be killed off by the DoH/NHSE is like being let down by a family member... Sad...Really Sad!

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  • right now things are bad so close your eyes and imagine what it is going to be like with the following;

    1. 7 day working with minimum 12 hr shifts and of course not enough staff to rota out safe working hours. add in catch up work and you are looking at 14 hr days 7 days a week for less pay.
    2. more stringent CQC,QOF, re-validation criteria as we must keep up 'quality'
    3. more stringent penalties (litigation, multiple jeopardy, imprisonment, GMC overturning judgments as they feel fit, prolonged investigation forcing you out of work)
    4. massive increase in defense fees who don't view weekends or OOHs work as core. increase in cqc, gmc etc fees. generally higher than inflation increase in expenses.
    5. more work shifted from secondary care and everywhere else as their budgets as cut.
    6. more and more demand from unhappy consumers (let's be honest we no longer have patients) in which you are to blame for any part of the NHS that doesn't please them
    7. falling pay to the extent that 50k a year offered to PAs seem a better deal.
    8. lack of support from everyone
    9. perpetual media bashing destroying the last bit of self-respect you have

    basically more risk, stress and a lot less reward (emotionally and financially).

    things are not going to get better - there is no light at the end of the tunnel.

    the RCGP, GPC have nothing to offer so I don't see things getting better. you could try throwing money at the problem but you will have to offer a lot more than 20k per GP and even then i'd take the money to speed up leaving ! money won't bring back goodwill

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  • @1:50 General practice is far beyond the point of no return. All that is left is to watch it pass away. RIP UK General practice and hello rest of the world :D

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  • This comment has been moderated.

  • Anonymous | GP Partner04 Feb 2016 1:50am

    You're assuming we have leaders with testes. Dr Coales was top drawer but rejected by the cardigans - and now her principle message is save yourselves.

    I, like you, once loved the NHS. But I see it doing unspeakable things to people I care about - professionals who worshipped it, but who don't understand why their self-sacrifice is in vain.

    We stand on a £3bn deficit in the NHS, or roughly half the GP budget, and JH is simply telling all the acute FDs to fiddle the books so it doesn't look so bad. He's buying time to devolve the blame to local authorities for when it falls over. At that point, expect co-pay, insurance or wholesale commercialisation.

    I admire you fight, but its time to declare TOD. Examine the evidence, and make a choice for yourself. Many here are simply explaining the rationale for their choices.

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  • Una Coales. Retired NHS GP.

    @1:12 pm thank you for acknowledging my efforts. We grassroots GPs all tried but enough banging one's head against a brick wall.

    How can we GPs compete when the Tories ease pressure on tax shellters for global giants? https://www.rt.com/uk/314239-tax-haven-transparency-conservatives/

    Why are workers paying income tax, NI, road tax, pension contributions, MDO indemnity, etc. while global tech giants save £100s of millions if not billions in tax? Cayman Islands is a British colony!

    The NHS could have been funded with the billions in uncollected tax. The public could have been offered a chance of saving the NHS with copayments. We haven't scrapped universities but asked our young to pay, first £3k a year and now £9k a year. But the Tories would rather close the NHS and hand healthcare over like a commodity to private companies with shareholders who will want to see profits for their investments.

    The longer you stay in the UK, the more you may end up with nothing to show, as now I hear even a place in a care home for a parent with dementia costs £7,000/month! Or £84k per year! Who can afford this?

    Best to find a country without a trillion pound deficit. Look for a country with a thriving economy, democratic principles and not socialism, as socialism fails in a nation with a £1.5 trillion public debt. Socialist-communism failed during East Europe/Soviet Union's recession, which is why the Berlin wall came down. There comes a time when a system runs out of spending other people's money, debts will catch up and sadly Generation Y are now paying the price.

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  • ....Then after all the existing pressures, the poor old remaining doctors will be faced by a new licencing/revalidation exam to be taken by ALL medics!!!! The GMC small fry guy told me this as I was coming off the register 'voluntarily'. The guy I spoke to realised it would not be popular on top of everything else we have to do- understatment of the year perhaps!
    Previous comments were right that some of us do keep coming back to this website despite having 'left' the profession as we still identify ourselves as being doctors.
    Personally even after I do not now have a licence, life is very much better now. No gloating intended at all.
    I accept I will I always be a bit sad as letting go my licence it was initially like part of my life dying. But far from being the end of the world, it was more of a beginning of a different more happy and much less stressed life. My prioriries have changed and I work now only on my own terms.
    My family have been very supportive and have appreciated all the extra time I can give to them now.
    So for anyone who is at their wits end, leaving really may be the option for you as after this loss comes new oppertunities!

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  • To 2.20 "the poor remaining doctors..."

    Poor? No! The answer is to freelance and just factor this persecutory cr@p into your fee. The harder they make it to practise, the more we should charge. Money talks!

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  • To 8.22, you go get em! You are right. The very few remaining doctors who are stuck here should indeed freelance and charge as much as they possibly can for their services. Only this will make it worthwhile. I salute you!

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  • "but what are our representatives GPC/BMA and RCGP doing about it?" Anonymous | Sessional/Locum GP03 Feb 2016 5:08pm
    There is a short answer nut not for family viewing.
    The longer answer is that these gong-grabbers (including LMCs) have no incentive to fire up as they have a comfortable life sitting in their posh offices WE are paying for.

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  • I am in the LMC. I go to meetings in my own time for NO pay. we are genuinely trying to do something, but all we can ultimately do is ditch the Contract, because to me and many LMC members, it is just impossible.
    But what do we do with a Govt. hell bent on squeezing us to death?
    Other than resigning, and going the way of the dentists, there really are very few options.
    I agree with everyone = it should not be like this. Like 150 am, we are perhaps too close to the NHS.
    Perhaps it is time to walk away.
    I think market forces will decide. If GPs continue to leave, there will be no one left.

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  • Have a read of this
    http://moneyweek.com/endofbritain/

    And if you think its bad now, wait until we have Boris at the healm. As the financial crisis hits, expect us to lurch to the right, like the US currently is doing with Trump. Then the culmination of investors looking for a safe haven in healthcare, and the privatisation ideology will culminate with TTIP. And JH will look like a pussycat.

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  • I was a salaried GP, and was squeezed to death in my practice by the senior partners and the patients. Workload was very high and patients were rude and litiginous and my physical and mental health was suffering.

    Out of sheer frustration, took up locum jobs for 4 years and was extremely satisfied. I did not care a shit whether I was over referring or asking for too many investigations as I acted in the best interests of the patients. I had seen too many GPs fobbing their patients without doing appropriate investigations or appropriately referring to secondary care all in the name of saving money. Needless to say patients were quite happy with me and would regularly see me rather than their own GPS.

    I have now emigrated about a year back, and life is too good. I am a better doctor now.

    So, all young doctors and likewise old doctors out there, it is better to locum or emigrate if possible rather than being stuck as a salaried GP/Partner.

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