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Independents' Day

One in four GP partners has considered handing back their contract

Exclusive More than a quarter of GP partners have considered handing back their NHS contract in the past 12 months.

The findings, based on a Pulse survey of nearly 500 GP partners, found that 27% of respondents had reached a point where they did not want to continue; 71% said they had not; while 2% said they did not know.

GP partners told Pulse the factors bringing them to the brink of resignation included trouble recruiting GPs, unmanageable workload pressures, concerns about premises costs and fears over litigation.

The BMA's GP Committee said the 'high' proportion of GP partners wishing to quit put the very 'foundation of the NHS at risk'.

Last month, Pulse revealed that pressure on GPs have led to 450 surgeries closing in the last five years, with 1.3m patients faced with attending a new location.

Meanwhile, the GPC said that more than 600 GP practices will close in England by 2022 if the Government fails to increase funding for general practice.

The Prime Minister announced a £20bn NHS funding increase over the next five years last week, however a spending plan for the extra cash has yet to be finalised.

However, ahead of the announcement health and social care secretary Jeremy Hunt said the long-term funding plan must have earmarked funding for boosting primary care capacity.

Dr Maria Carrasco, a GP partner in Surrey, said there are days when she thinks ‘I cannot actually do this anymore'.

As a single-hander she is struggling with recruiting doctors and thinks GPs are being unfairly scapegoated for the crisis in the NHS.

She said: 'I am finding it really hard to recruit a salaried GP because I think it’s more attractive for GPs to be locums. But that is not sustainable.'

She added: 'Scapegoating GPs for the NHS crisis is unfair but that is what is happening and taking a massive toll on the profession and morale – a big reason why so many are leaving.’

Dr Sarah Hood, a GP in Bedfordshire, said she had ‘given serious consideration to handing back my contract for a number of reasons’, including ‘precarious practice finances’, and uncertainty over the future of the GMS contract.

She said: ‘There are no rewards for running a quality practice. Despite achieving a 97% patient satisfaction rating, having low referrals and under-budget prescribing, the only way [my practice] can access resilience funding is to apply for financial support in the event of a merger.

‘Understandably job satisfaction is wearing thin and you begin to question the merits of working yourself into an early grave.’

Dr Richard Vautrey, BMA GP committee chair, said: ‘To see such a high proportion of GPs, according to this poll, considering handing back their contracts is of little surprise given current workload pressures being experience by GPs and particularly GP partners.

‘While general practice struggles with increased demand, workforce shortages and stagnating budgets, GP partners face all of the added stresses and risks associated with buying into a small business, managing the practice premises and recruiting staff.'

An NHS England spokesperson declined to comment on the survey results but highlighted the review currently taking place of the GP partnership model.

Dr Vautrey said the BMA will be feeding in to that review 'to ensure the core principles behind general practice are preserved', as the demise of partnership would threathen the NHS's future.

He said: ‘As more GPs turn away from the partnership model, in which doctors have a direct and longstanding connection with local communities and are on the shop floor of their own businesses every day seeing and treating people face to face, puts the very foundation on which the rest of the NHS is built at risk.'

He added: ‘More widely, as seen by the most recent workforce statistics, general practice is in the depths of a recruitment and retention crisis and the Government and NHS England need to take urgent action to make the profession an attractive and sustainable career choice once again.’

Chief executive of Wessex LMC Dr Nigel Watson has been appointed to chair the review, which will look into how the partnership model needs to evolve in the modern NHS.

The news comes as a report by former Labour health minister Professor Lord Ara Darzi recommended that the NHS offers all existing GP partners to become employees of the NHS.

Have you at any point over the past 12 months considered handing your contract back?

Yes: 27%

No: 71%

Don’t know: 2%

The survey was launched on 12 April 2018, collating responses using the SurveyMonkey tool. The 28 questions asked covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a Ninja Coffee Bar as an incentive to complete the survey. A total of 462 GP partners answered this question.

Readers' comments (10)

  • How do we know that is different from any time in history.......?

    Also 1 in 8 Americans thinks Elvis is alive!

    Don't forget we are scientists.

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  • Vinci Ho

    These ‘figures’ are strategic (not necessarily believable) when this big narrative about new funding of £20 billion more annually for NHS , comes on aboard . The health secretary yesterday stressed that NHS must come up with a ‘big plan’ of changes before this new money will be granted , echoing what the PM said previously.
    So , here is the thing , the government needs us more than we need it . Our representatives/negotiators should always remember this in their mind . Yes , perhaps we may have to compromise a bit in the final ‘plan’ but the government (especially if the PM still wants to retain her position) , the government must sacrifice a lot more for us .
    And of course , if our health secretary wants to become the next prime minister , in case of a desperate leadership contest( which tactically , I advise him to appoint Sarah Wollaston as health secretary and the current Home Secretary where he is), he will have to be even more ‘understanding’.
    In times like this , I suppose nobody shows nobody any mercy on the political arena.......

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  • AlanAlmond

    How do we know General Practice is in the mire? What evidence is there that these figures arent exactly the same as 20 years ago? Nobody did this research then as a baseline ...therefore this reasearch means nothing, can be ignored and the truth is actually more likly that GP partners are really happy.

    Look at all the other evidence out there, the falling GP numbers, the difficulty in recruiting partners, the brain drain out of the country. There’s nothing to suggest that this research has even an ounce of truth in it. There’s no base line measure.

    I’m a rampant atomist by the way. I live in a evidence bubble and all my clinical decisions are based on randomised control trials. If there isn’t a randomised control trial backing up my practice I just tell my patients to go away cause there's nothing I can do, because ‘there simply isn’t the evidence’. I’m a scientist after all, and so should you be if you want to call yourself a Dr. So there.

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  • A lot of cant, shackled to the sinking NHS galley like slave by liabilities like redundancy payments and lease etc..But these liabilities are unlikely to attract anyone in a period of 15 year pay restraint.

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  • "How do we know that is different from any time in history.......? "

    I can offer a small amount of evidence. All of which is anecdotal. I have seen several practices close down or merge locally. I am going to have to wind down my own Practice as it is no longer viable. My accountant tells me that loads of his clients (all GPs) are retiring earlier or closing up shop. No one is responding to my adverts to join us. A lot of the locums we use are in their 30s and 40s and used to be Partners. Not sure if this is just a local glitch.

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  • Merlin tis a national disaster unfolding.

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  • One of the best markers of the issue is number of applicants for each salaried/partnership post. It would be interesting to see how this has decreased as I remember 10-15 not being unusual some years ago, and now you're lucky to get anyone

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  • As we have seen in Northern Ireland, when push comes to shove they will do nothing.

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  • No “hard” evidence.
    Just (literally) scores of applicants for GP partnerships in the 90’s and as a profession back then we were wondering how to get 70 year old GPs to retire, they loved the job so much.
    C.f. Now - we can’t find any applicants and GPs in their mid-50s can’t wait to get out with no intention to do any Locum work.
    QED. For me, at least.

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  • QED

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