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RCGP demands action to avoid 19,000-strong ‘mass exodus’ of GPs and trainees

RCGP GPs

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.’

The RCGP’s survey also revealed that:

  • 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:
  1. A nationally ringfenced retention fund of at least £150 million annually for GP retention and career development programmes.
  2. 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.
  3. 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.
  4. 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.

Source: RCGP

READERS' COMMENTS [13]

Vinci Ho 22 June, 2022 10:02 am

These are ‘old’ demands being cried out long time but the question is , do our paymasters really care and come up with actions ? There is always a point beyond which things become irreversible. Well , have we reached that ? 🤨👿

Turn out The Lights 22 June, 2022 12:33 pm

We reached that a long time ago Vince.To late to change what is happening.

David Evans 22 June, 2022 2:05 pm

I have been a full time GP for 22 years. I hope to hang on to 2027 (when I am 55) and then that’s it. Nothing would make me stay on a second longer.

John O’Malley 22 June, 2022 2:39 pm

I was wondering what was needed to happen. But then a letter. Gosh, the Government must be quaking. Hopefully, the RCGP didn’t put a stamp on it so the Government would have to pay.

Dave Haddock 22 June, 2022 3:09 pm

Abolishing Appraisal and Revalidation would help, and unlike all the he RCGP suggestions would save rather than cost money.

Patrufini Duffy 22 June, 2022 3:45 pm

I am convinced the Americans and Harvard graduates are well seated in the RCGP, CQC, GMC and DoH. Pulse just has to do a new list of 50 seedy individuals.

Keith M Laycock 22 June, 2022 5:30 pm

NHS GP practice may well be in dire straits but how reliable are these extrapolations of impending doom and how the are reported in the media.

The high percentage figures (68% & 80%) of dissatisfaction relate to the 2.8% (1262) of the quoted 45,000 current GP & trainees: 1.9% and 2.2% of the GP cohort.

Actual decline in GP numbers given as 4458 in 9 years but an assertion that there will be a 19,000 decline over the next 5 years.

This is apparently based on 42% of the 1262 survey respondents, namely 530. It seems a large leap from 530 to 19,000.

“Extrapolating’ and “could mean’.

That said, the proposals listed are likely, as per the other comments, just blowing in the wind.

Long Gone 23 June, 2022 7:56 am

Well done the RCGP!
But let’s just review how we got into this mess – a toxic alignment of CQC, A&R, GMC, ageing population with multiple complex chronic diseases, pensions, media vilification, political preoccupation with secondary care – I could go on….
So the idea that anyone could pull all of the necessary levers strongly enough, quickly and in a coordinated way to slow, halt or reverse this decline is fanciful.
We are heading for some kind of acute trust run, impersonal, cheap and politically expedient service. Ever been a patient on the receiving end of “working at scale”? If you have, you’ll get it.
It took a good few years to boil this frog. And you cannot unboil it. It’s cooked. It’s an ex-frog. It is no more. No matter what the RCGP, BMA, or anyone else might say.
I lament the passing of personal, effective and humane general practice. I just about saw the tail end of it in the late 80’s. What followed was the start of this journey. We are now at the end.

Dave Haddock 23 June, 2022 11:30 am

On the up-side, the worse NHS Primary Care gets, the more opportunity to escape the ghastly NHS into Private Practice.

Hot Felon 23 June, 2022 4:25 pm

Already exodussed.
And blissfully happy.
No Sunday evening feeling, no woke nonsense, I can offend anyone with impunity and hate on people when I like, not forced to work with autistic rude freaks who I can’t stand.
No diversity or terrorism modules.
No IT failures.
No rejected referrals.
No GP to chase up referrals.
Bye to the bollocks.
See you south of Spain in September

C Ovid 26 June, 2022 8:45 am

Too late, too late, too late, too late.
Is that enough said?
Negligent attitudes to Workforce Planning, and an utterly predictable deluge of complex frail elderly (George Magnus “Age of Ageing” ), and a superficial set of politicians who can’t see any further than the next election soundbite.
NHS General Practice is such a toxic place to be right now, and there are better hourly rates at KFC if you REALLY add the hours up.
I’m out of here next year.
Good luck to the Professional Bodies and NHS mandarins: morons the lot of you.

C Ovid 26 June, 2022 8:59 am

@Long Gone. Wonderfully put. Thank you.