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The waiting game

Nine in ten GPs work extra hours every week as a third cut clinical time

A total of 90% of GPs are working beyond their scheduled hours on a weekly basis - up from 79% last year - while more than a third of the profession have cut their clinical hours in the past 12 months, a major GMC report has shown.

The regulator's annual UK-wide report on the state of medical education and practice warned GPs are at 'particular' risk of burnout due to high workloads and the pressurised environment they work in. 

Almost one in ten (9%) family doctors have taken a leave of absence in the past 12 months, according to the report, which surveyed 1,079 GPs out of a total of 3,876 doctors between June and July 2019, 

In the past year, clinical hours were cut by 36% of GPs, a figure 'markedly higher than other registration types', highlighted the report.

A total of 46% of GPs are contracted to work less than full time, a group that is more likely to be more satisfied with their work - and less likely to leave the profession - than those working full-time hours.

The report suggested working less than full time 'may be a protective factor against burnout' as 27% of full-time GPs were deemed at 'high risk' of burnout, compared with 20% of those on fewer hours.

The GMC's chief executive warned increased complexity of cases and rising patient demand was driving GPs to cut hours - and that recent boosts to the number of GP trainees would not be enough.

GP leaders have stressed the profession should not be criticised for reducing their clinical hours, a move that can mean they do not leave their jobs altogether. 

The regulator's publication, released today, looked at the challenges and opportunities in primary and secondary care.

It also shows that: 

  • 65% of GPs work beyond rostered hours every day;
  • GPs indicated the highest risk of burnout compared with other register types, with 25% indicating high burnout risk;
  • 9% have had to take a leave of absence due to stress in the past year;
  • 56% of GPs working less than full time were satisfied in their job, compared with 49% of GPs working full time;
  • 9% of GPs working less than full time are considering leaving the profession in the next year, compared with 13% working full time;
  • Asked why they were considering reducing their contracted hours, 71% of GPs said their current role was too demanding. Almost half (46%) said the current system presented too many barriers to patient care.

GMC chief executive Charlie Massey said: ‘The clinical work of GPs is changing. They’re seeing more patients, many with complex needs and some who have high expectations of what primary care can do for them.

‘That’s one reason why we’re seeing more GPs choosing to work less than full time, and many planning to reduce their hours in the next 12 months.

‘It means that while there are welcome increases in the number of GPs coming out of specialty training, this is not keeping pace with demand.'

RCGP chair Professor Martin Marshall said: 'It's not surprising to see more GPs reducing or planning to reduce the number of clinical hours they work. They shouldn’t be criticised for this - it’s this flexibility in working patterns that general practice offers that makes the job sustainable, so that GPs and our teams can continue to deliver safe care to a million patients a day across the country.

'Working "full-time" in general practice is simply not doable for many, and this is causing GPs to burn out, or leave the profession earlier than they planned to because they feel they cannot guarantee safe standards of care for their patients. It makes sense that GPs are making choices about their career to safeguard against this.'

Professor Marshall called for more measures to reduce GP workload, boost investment and increase the size of the workforce.

BMA council chair Dr Chaand Nagpaul said: 'Crucially, as this report notes, exhausted and burnt out doctors, overwhelmed by demand, are struggling to provide the level of care that patients deserve.

'This is affecting quality and safety of the care that’s being delivered. It’s clear that the impact of the state of the NHS is being felt across the whole profession – from juniors beginning their careers, to experienced hospital doctors and GPs.'

Research by The King’s Fund showed that only one in 20 GP trainees see themselves work full time in general practice  in 10 year's time.

Latest NHS Digital statistics showed that the number of fully qualified full-time equivalent GPs in England has dropped by 339 over the past year

It comes as the number of GP appointments rose to around 30.8m in October, the highest ever recorded in a single month. 

Readers' comments (28)

  • What is full time for a GP?
    Officially I think it is supposed to be 37.5 hours a week....
    I easily work over 50 hours and I am supposed to be part time.
    I suspect that a lot of those who say that they are working part time are actually working huge hours. It is nonsensical.

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  • The GMC could help reduce pressures by by suspending Appraisal and Revalidation, an intervention of no proven benefit and a significant contributor to workload, stress and premature retirement.

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  • I strongly recommend that GPs don't read the DM today, this is being 'reported' and the comments are as expected. The general consensus is once again that GPs are overpaid for an easy job. I reduced hours four years ago and haven't looked back. I left and now have a non-medical internet business and work 30hrs a week, have lunch every day and no-one tells me I earn too much for an easy job. Good luck.

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  • @Honest from Yorkshire - are you recruiting?!

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  • It's my final day ever as a GP tomorrow, and I am sad but relieved to be leaving, aged 44. The Daily Mail comments certainly help to assuage any guilt I might be feeling about leaving.

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  • @Travel-doctor.
    I am afraid that we are and it doesn't make good reading for GPs. We are currently interviewing for a Financial Director, likely to be the woman we met yesterday but a few more to see next week before deciding. The job is 37hrs a week, office based, lunch break daily, health insurance, sickness and maternity benefit, pays £75K or a bit more for the right candidate with profit share likely to add a further £20-40K. The candidate yesterday was 32yrs old.

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  • The ship is sinking. We have been trying to warn policy makers of this for years. I suspect GPs working part time are still doing the workload done by full time GPs of old (in terms of the numbers of patients seen, and number of problems, and medications dealt with). We will never keep up with the burgeoning demand. FATPOA is no longer sustainable, if we battle on trying to save it, we will destroy the whole service. Whats the point of 'free but no access at all'...?

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  • GPC and Cardigans must stop colluding in the managed end of general practice.
    New contract - now; or we do wha the dentists did, and the nhs can buy from us whatever services it can still afford after it has paid for its Apps, algorithms, social prescribers, pharmacists etc.

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  • Dear RCGP, please respond to the Mail and secondly in before 0800 and leave after 1700 on a “half day” - lazy GP only doing a 3 hour surgery.... That is Real GP in 2019 and I can’t see where the so called flexibility is. Another year of College S**t hanging us out to dry I see....

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  • Wow just read the daily mail article on this:

    The general public are treating NHS staff like items for sale in a vending machine!

    "I'll have one doctor please. What nothing came out when I pressed the button!!! I want to speak to the manager!!!"

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