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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'm 49. I have paid off my mortgage, children are independent. I am looking to do something else in 3-4 years but should there be any imposition of OOH I will resign from my partnership.

    I just hope I can get my resignation in first ……

    The government is making a massive miscalculation as to how far he can push GPs. Collectively we may be weak but individually some of us have been making other plans so we can escape from this madness.

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  • 50y - 0y!

    I have just left the NHS and the UK after 20 years (hence no more irrate comments "moderated by the editor" from me on this site...) and I DO NOT intend to come back!

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  • Oz ain't the holy grail lads, it's better but there talking of capitation.... the mind boggles!!!!!!!!! should have been a vet......

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  • 48 - I don't want to be forced out. Had previously planned to work until 65. Cannot find replacement partner - not for want of trying. Don't know how much longer I can go on waking up feeling sick at the thought of another 12-13 hour day. Still, I can always look at the Daily Mail to boost my self-esteem.

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  • 41y - moved to Oz 3 years ago - NHS was getting to me even then, minimal respect from punters, treated like a referral secretary, 10 minute in and out and QOF. I do recommend Oz but the door will close soon as they are training-up more of their own docs.

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  • nothing new here.all the partners have sucked the system dry since 2004. they have been on the gravy train.all money. no evenings or weekends. have filled their coffers with rent, qof, what not while making slaves / salaried gps work.now they r crying like a spoilt child whose chocolates are being taken away. no sympathies for these selfish parasites.things will improve if this dead wood actually goes.

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  • @12.08
    Please do not tar "all" partners with the same brush.
    We have always had a policy of making all doctors partners who wanted it.
    In return, not only have we earned less, but we do all the unpleasant tasks ourselves strictly by profit share.

    Each generation has their own difficulties.
    As a junior hospital doctor I did 1:2 rotas for 1/3 normal pay for all hours in excess of 40.
    As a GP trainee I was in call on a 1:4 rota all night and weekend totally unsupported. Trainer at home in bed and not willing to be disturbed.
    As a new partner, for several years, we did the same, and in fact had our home number on the surgery answer phone so patients would keep it and call any time they liked.
    Yes, our generation have benefitted from rises in house prices and fee university education, but my endowment " with profits" policy recommended by the BMA not only gave no profit, but fell short by a third. Yes, we have had good pension provision but this was part of the overall package to make up for lower than private sector pay.
    In the mid 80s pay was so low that there was a major catch up increase across the board.

    The bottom line is that each generation has a different experience. I agree that some partners ( including possibly Clare Gerada) have taken advantage of the contract since 2003. Others have not. Equally a lot of younger doctors do not want partnership and the financial and management responsibility that goes with it.

    The government have done a brilliant job of divide and rule. The bottom line is that we are all being shafted and they have us arguing about how lucky the other group is. Genius!

    The world did not start in 2003, and the reason the contract changed then was because the situation before was so dire. Those of us in our 50s lived through that and some of us feel that some of the younger generation lack commitment and are a bit lazy. Two sides can play at that game, but the game will only end in destruction for us all.

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  • Ps. I think you will find that the partners in charge of large practices with loads of salaried doctors aka Clare Gerada are not the ones who will leave, but the fair minded and hard working ones.

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  • My stress is caused by another GP ..., problem is not outside but inside our community ... keep ignoring this ...

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  • 43 - been wanting to quit for ages but single parent with kids in private education and uni to pay for so not likely to happen anytime soon.
    However I have poor health so imagine I will be forced to stop when this fails completely. No pension - unable to afford to pay into the system.
    Likely to leave surgery in a box.

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