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Independents' Day

GPs suffering highest stress rates for 15 years, finds DH study

GPs are suffering the highest levels of stress recorded since 1998, with over half of those aged over 50 years saying they intend to quit direct patient care within five years, a DH-commissioned survey has found.

The national GP worklife survey - carried out by researchers at the University of Manchester - found the number of GPs over 50 intending to quit direct patient care has increased by 30% in the last two years.

The news comes as Pulse launched its Battling Burnout campaign earlier this year, which urged GPs to write to their MP to raise awareness to the issue. This followed from an investigation which found that almost half of GPs were at a high risk of becoming emotionally exhausted, depersonalised towards patients and feeling like they are not making a positive contribution to people’s lives in their job.

The national GP worklife study also found that stress in GPs was rising. In terms of job satisfaction, it revealed that on a seven-point scale where 1 means ‘extremely dissatisfied’ and 7 means ‘extremely satisfied’, average satisfaction had declined from 4.9 points in 2010 to 4.5 points in 2012 in both the cross-sectional and longitudinal samples.

GPs were least satisfied with hours of work, recognition for good work and hours of work, with the largest decreases in job satisfaction between 2010 and 2012 in the domains relating to hours of work and remuneration.

The survey also found that almost a third of GPs indicated there was a considerable or high likelihood that they would quit direct patient care within five years.

For those aged 50 years or over the corresponding figures was over half (54.1%), with the vast majority of these indicating that the likelihood was high. The average reported age of planned retirement was 61 in a range of 52 to 76 years.

The proportion of GPs expecting to quit direct patient care in the next five years was at the highest levels since the survey began in 1998. It had increased from 41.7% in 2010 to 54.1% in 2012 amongst GPs aged 50 years and over and from 6.4% in 2010 to 8.9% in 2012 amongst GPs under 50 years-old.

Reported levels of stress increased between 2010 and 2012 on all 14 stressors, generally by 0.2-0.4 points on a five-point scale where 1 means ‘no pressure’ and 5 means ‘high pressure’.

In 2012, as in 2010, GPs reported most stress due to increasing workloads, paperwork and having insufficient time to do the job justice, and the least stress reported due to finding a locum and interruptions from emergency calls during surgery.

Almost 70% of GPs agreed to some extent that they did not have time to carry out all their work, and that they were required to do unimportant tasks, detracting from more important ones, but that they always knew what their responsibilities were.

95% of respondents were likely to agree to some extent with the statement that they had to work very intensively, 84.1% that they had to work very fast, but 82.5% agreed their job provided a variety of interesting things.

Only a tenth of respondents agreed that changes in the job in the last year had let to better patient care.

The seventh national GP worklife survey concluded: ‘The 2012 survey reveals the lowest levels of job satisfaction amongst GPs since before the introduction of the new contract, the highest levels of stress since the start of the survey series, and a substantial increase over the last two years in the proportion of GPs intending to quit direct patient care within the next five years.’

GPC chair Dr Chaand Nagpaul, said: ‘It is not surprising that the authors of this government funded report reveal the lowest levels of job satisfaction amongst GPs since before the introduction of the new contract and the highest levels of stress since the start of the survey series.

‘General practice is under real pressure from spiralling patient demand, especially from an ageing population, and falling resources. Recent increases in targets and pointless box ticking have added another damaging level of bureaucracy that is diverting valuable time away from treating patients.

‘GPs want to work with the government to improve patient care and to be freed from the administrative nightmare that is adding unnecessary workload to an already overstretched service. I hope this important report can help us do that rather than being a source for misleading point scoring.’

A spokesperson for the DH said: ‘We know that GPs - like the rest of the NHS- are working extremely hard in the face of increasing pressures.

‘It is essential we strengthen general practice so we can provide the excellent care our patients need. As part of our Vulnerable Older People’s Plan, we want to make sure our most vulnerable and elderly people to stay in good health for longer and are kept out of hospital.

‘We have asked GPs for their views on how we can remove some of the barriers to offering better, more integrated care. We want GPs to work with us on fundamental changes to the system so that it works for them and patients.’

The report also found:

·         0.3% increase in hours of work compared with the 2010 survey, with GPs reporting they work on average 41.7 hours a week

·         Most respondents to the survey agreed that GPs added value in commissioning roles, but were divided about whether commissioning was part of their role as a GP. They expressed concerns about the impact that CCG introduction had had on their personal workloads and the time they could spend direct patient care and continuity of care.

·         More than two thirds of GPs thought that practice income should not be related to CCG performance at all, with only 3% agreeing that in excess of 10% of practice income should be related to the performance of CCGs.

Readers' comments (74)

  • I hate to talk up a crisis but........

    At ground level it is apparent that there are increasing problems with recruitment, indeed seen from the perspective of older GPs it does seem that younger doctors are less willing to take on the challenges of partnership (many will say, who can blame them?).

    Browsing the Internet for more information on this topic (recruitment difficulties in GP) I came across a paper from Somerset LMC dated 2002 -- which makes me realise that this is really a long-term system failure, perhaps because general practice is so undervalued and under resourced?

    A cynic might comment that soon the government will have to find somebody else to blame -- because there will be no GPs left on whom to pin blame for all the perceived failings of the NHS, itself an institution which seems to be, perhaps unfairly, held to account for failings of wider education, social and economic policy in the UK.

    Any bloggers today recommending VER or emigration? I take the point.

    On a positive note, perhaps there will be re-engagement between government and GPC, sensible discussions and negotiations about how health care should be organised in the primary carer sector over the next number of years in the UK -- and sensible plans and resources put in place to achieve those goals eg if it's going to be health maintenance model, GPs should be brought out of their premises, there should be adequate resourcing for up skilling of the primary care work force, there should be increased recruitment into primary care both GPs and other healthcare professionals which is also fully resourced etc

    Do I think that will happen? Sadly not.

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  • Let's face it - the govt doesn't really care about the results of this survey. They will only really care when the service is endangered or when practices start closing and explaining to patients why the govt is to blame.

    Anyone who thinks they give two hoots about our wellbeing is totally mistaken.

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  • Vinci Ho

    Yes, you wonder what is political motive of DoH doing this kind of survey?
    Mind you, Mao and Stalin did try to convince people there was democracy in their country.........

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  • sooner or later the nhs will be privatised.workload will reduce as all the dross we see because the service is free,will stop.everyone happy,except the dross.

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  • Let's see why don't we all comment:
    Age- no. of years willing to stay!


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  • 59,still have loads of energy but am def going soon.had enough of this crap.

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  • 43y-5years and already starting private work on the side as an insurance policy....move to US if no improvement in next 5 years...

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  • 31y - 2y already looking into Canada plan move in 2015....

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  • 49y - 1y

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  • 51 -1 year also

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