The RCGP is predicting that nearly 19,000 GPs and trainees will exit the profession in a ‘mass exodus’ over the next five years, unless workforce and workload issues are urgently addressed.
The college is launching a new GP sustainability campaign on the back of a survey which revealed 42% of GP and trainees say they are likely to quit the profession in the next five years, with 10% in the next year and 19% in the next two years.
Extrapolating the 1,262 responses across 45,000 current GPs and trainees, this could mean patients losing 18,950 GPs and trainees, or 15,000 full-time equivalent GPs, the RCGP warned.
Among reasons for quitting, 60% cited stress, working hours, and lack of job satisfaction.
One GP partner in London who said they were planning to quit told the RCGP: ‘I cannot continue working in a system that seems to continuously fail its workforce and keep demanding more for less with no staff.’
In response, the RCGP’s new campaign urges the Government to set out a new recruitment strategy, including increasing GP training places by 10% year on year and changing visa rules to make it easier for international GPs to stay and work in the UK.
The RCGP also wants an ‘NHS-wide campaign’ to free up GP time with patients by reducing unnecessary workload and bureaucracy, including ‘through a review of contractual requirements and improving coordination between primary and secondary care’.
And it wants new IT solutions for practices including systems that would allow patients to see the same GP or the next available doctor.
The RCGP is also reiterating long-standing calls for the general practice budget to be restored to account for 11% of total health spend, including a £1bn investment in GP premises as well as extra money for practices serving deprived areas and for PCNs to do more preventative work.
And it repeated calls for a move away from QOF, and towards ‘a system that encourages GPs to focus on those who need care most and cuts out the red tape and box ticking’.
A salaried GP respondent to RCGP’s survey, based in London, said: ‘Tick box performance indicators mechanically delivered on seem to trump consultation time, quality and continuity of care.’
- 68% of respondents say they don’t have enough time to properly assess their patients, with 65% saying patient safety is being compromised due to appointments being too short.
- It is impossible for most GPs to manage the workload required in the time allocated, meaning on average they work 10 hours more a week than their contracted hours.
- 80% of respondents expect working in general practice to get worse over the next few years, compared with only 6% who expect it to get better.
- Over a third (38%) said GP practice premises are not fit for purpose, and IT for booking systems are not good enough (34%).
Referring to the survey findings as ‘alarming’, RCGP chair Professor Martin Marshall said: ‘Our survey results should act as a stark warning for politicians and decision-makers – and we urge them to take heed of our campaign, launching today.
‘This outlines what is needed to make general practice fit for the future, so that GPs and our teams can give the patients the time and care they need. Taking these steps will alleviate the unsustainable and unsafe pressure that GPs and our teams are working under, and free up time to have longer consultations and build the invaluable relationships with patients that we know lead to better health outcomes.
‘Being a GP is a fantastic, stimulating and professionally satisfying career, when it is adequately resourced and when we have the time to deliver the care our patients need, and the type of care that we want to deliver. We need to make being a GP sustainable again, for the sake of the NHS, and for the sake of patients.’
BMA England GP committee deputy chair Dr Kieran Sharrock said the Government can ‘ill afford’ to ignore the RCGP’s ‘stark warning’.
‘The number of fully-qualified GPs is already plummeting, meaning each day more people are losing “their family doctor”, and such projections lay bare the potentially devastating impact for both the NHS and patients if politicians and policymakers fail to act,’ he said.
‘While GPs and their teams are doing all they can to ensure patients are seen at their practice when they need to be, current levels of workload are unsustainable and unsafe for both patients and staff. This will only worsen if we continue to haemorrhage doctors.’
Ministers ‘must work with the profession and organisations such as the BMA and RCGP to come to workable solutions’, he added.
Yesterday, the Labour Party tabled a motion for an urgent debate on the ‘crisis’ in general practice, after its analysis found that 4,458 GPs were lost to the NHS in England between 2013 and April this year.
Health secretary Sajid Javid said last week that he will be setting out a ‘plan for change’ for primary care, as the current model is ‘not working.
RCGP demands in full
- Create and implement improved IT systems which make it easier for medical staff to share patient records and information about what they need to improve relationship-based care.
- Eradicate unnecessary bureaucracy in general practice to enable staff to focus on patient care.
- Introduce changes to the way we deal with the most vulnerable patients moving away from the current Quality Outcomes Framework to a system that encourages GPs to focus on those who need care most and cuts out the red tape and box ticking.
- Improve the experience of accessing care, making it easier for patients to choose to see the same GP or the next available member of the team, achieved through investing in better booking system and organisational development.
- Make it easier for international doctors who complete their training as NHS GPs to apply for long-term visas to stay and work in the UK, bringing the situation into line with trainee doctors in other parts of the NHS.
- Allocate a greater proportion of NHS budgets to general practice to return funding to 11% of total health spend. This should allow investment in:
- A nationally ringfenced retention fund of at least £150 million annually for GP retention and career development programmes.
- Additional funding of at least £100m per year to develop primary care networks to take a lead role in transforming patient care and population health. This should include funding to employ community health leads, increased funding for Clinical Directors or management staff and support to help practices work at scale and to implement new ways of working.
- Extra funding for practices serving the most deprived populations to recruit and retain staff in under-doctored areas, as part of a comprehensive review of the Carr-Hill formula.
- Investing £1 billion to make general practice premises fit for purpose, including sufficient space to accommodate expanded multidisciplinary teams.
- Publish a detailed plan to achieve and go beyond the targets of 6000 extra full time equivalent GPs and 26,000 additional staff in non-GP roles. This should include measures to:
- Make the funding rules more flexible so practices are free to use money from the Additional Roles Reimbursement Scheme to hire the staff they need, including nurses, and invest in supporting supervision and training to better integrate teams.
- Expand the number of GP training places by at least 10% year on year. This must sit alongside action to increase the number of trainers and improvements to premises to further expand teaching in general practice.