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The NHS must stop ‘haemorrhaging’ GPs to other countries, says GMC chief

The NHS must stop ‘haemorrhaging’ GPs to other countries, says GMC chief

The UK must stop ‘haemorrhaging’ GPs, who are ‘voting with their feet’ to go work abroad, the GMC chief has warned.

In a speech today to the NHS Providers conference, chief executive Charlie Massey referred to recent GMC analysis which showed burnout to a be a major factor contributing to GPs deciding to leave UK general practice.

On the whole, doctors decide to leave the UK for eight main reasons, the GMC’s research found (see box), none of which are actually related to a wish to stop practising medicine.

These included doctors seeking better pay, but also those who have become ‘disillusioned’ with the UK’s health system.

In response, Mr Massey called on healthcare leaders and employers to act now to stop the ‘senseless waste’ of talent.

He said: ‘What this research tells us is that many doctors are not leaving UK practice because they have fallen out of love with medicine. Instead, it is because they can’t tolerate the environments in which it is practised. The problem is not their work, it is their workplace.

‘This is a senseless waste of talent, not least because these issues are preventable. With a focus on compassionate, supportive cultures, they can be put right. This will not only improve doctors’ wellbeing, but also their productivity. Happier workers are better workers, and they deliver better results.’

A ‘good first step’ to improve the situation would be to reform rules so doctors in non-training roles can work in general practice, Mr Massey added.

Last month, the GMC called on the governments of the UK to change legislation to make it easier for qualified doctors to enter the GP register to solve recruitment problems within the profession.

This would enable GP practices to recruit staff and associate specialist (SAS) doctors from the UK or potentially directly from overseas, the regulator suggested.

GMC research suggests ‘around half’ of doctors who give up their licence to practise in the UK each year intend to continue their medical career abroad.

GMC researchers identified ‘key trigger moments’ for departing doctors, which they said included:

  • Personal – including wellbeing issues, life stages such as buying a home, divorce or children leaving home, or financial issues.
  • Professional – including negative workplace incidents, reaching a career crossroads, being headhunted or approached by a recruiter, witnessing the overwork, poor health or even death of a colleague.
  • Sociopolitical – including Brexit, political decisions impacting the NHS and visa issues for them and their families.

Mr Massey said: ‘There is no cavalry coming over the hill. The next few years will arguably be the hardest the NHS has ever faced, harder even than the pandemic. Resolving the issues that brought us here will require huge resolve and commitment.

‘There are more than 350,000 doctors on our register. Think what a difference it would make if every one of them stayed in UK practice even six months longer. The benefits would be vast. So, it is time for all of us to roll up our sleeves. Watching our health services haemorrhage talent is not an option. We simply don’t have the luxury of being defeatist.’

Last week, GMC was among regulators who said they will take into account winter pressures when investigating complaints against doctors relating to their practise during the ‘difficult time’ that will be the coming months.

Why doctors leave the UK

  • Burnt-out GPs: while many doctors in our study mentioned experiencing burnout, there were some specific issues in primary care driving GPs to migrate. 
  • Career-limited doctors: international mid-career doctors who felt that they had exhausted all possible career opportunities in the UK. 
  • Disheartened EU and international doctors: doctors in their mid-career, often with young families, who recounted negative experiences at work, directly or indirectly, in relation to their identity as a foreign national living and working in the UK. 
  • Disillusioned doctors: mostly UK-trained doctors in their mid to late career who were driven to migrate due to frustrations with the health system in the UK.
  • Internationally mobile doctors: consultants in their mid-career who had plenty of previous experience abroad, working in different countries whenever the opportunity allowed or when administrative or visa issues determined. 
  • Older explorers: older doctors who had spent most of their career working within the NHS, seeking adventure, a new professional experience or a challenge. 
  • Salary seekers: typically made up of men in their 40s who had come to a point within their career when they realised that their current salary and future salary prospects were not sufficient to sustain the quality of life they desired. 
  • Young explorers: this group was made up of early-career, UK-trained doctors who typically had travel in mind from medical school, seeking fun and adventure.

Source: GMC, ‘Understanding doctors’ decisions to migrate from the UK’


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Please note, only GPs are permitted to add comments to articles

Decorum Est 16 November, 2022 2:38 pm

Mr Massey said: ‘There is no cavalry coming over the hill to save you docs. So you might as well knuckle down and do as your told!

Patrufini Duffy 16 November, 2022 2:44 pm

Convincing yourself that you’re not a Top reason is tomfoolery and delusional. Here’s the actual top 5:

– CQC and unintelligent monitoring
– UK public/nanny state -patient first, you second
– institutional racism
– media and scapegoating

Add the icing of zero perks, but a mere rubbish Blue Light card and 20% off Nandos and crap hours/social responsibility and ample knowledge you can get better progressive employers in 2022. Much better. The UK clinician is a top dog, high value world asset – not as stupid as you think or treat them and the system is idiotic to let high-quality, multifunctional, cost-saving English speaking Consultant Everything Generalists vanish. Idiotic. I am filling in a form for an ITU nurse heading off to Saudi Arabia. And I met an AMU registrar who’s said 6/10 of their friends have left training. It’s great to have head hunters everywhere in the e-commerce trillion dollar medical industry. People are not interested in your lota anymore, that villify and want to cut heads off carers. The GMC board should all take a 75% pay cut, then see if they really like “it” and their self-made plugging.

Cameron Wilson 16 November, 2022 2:48 pm

Appraisal and revalidation, you can start with knocking that on the head! You could equally make it easier for experienced GP’s to help out without having to jump through the hoops of safeguarding, fire safety etc,etc. You could also stick your oar into sorting out the litigation garbage afflicting this country and suggest some no fault system, you could also suggest that CQC is an unnecessary burden and put the GMC voice behind knocking that on the head! Admittedly, all the above would mean the GMC changing direction but their current course has contributed to the loss of GP’s . The ball’s in your court Charles!!

Turn out The Lights 16 November, 2022 3:00 pm

Near choked on my tea reading this BS for the witchfinder general.

Kevlar Cardie 16 November, 2022 3:19 pm

That Turboschlong is a fully paid up member of DENSA.

Fedup GP 16 November, 2022 4:23 pm

Not that relevant – but – GMC salaries

Name Position Salary
Charlie Massey Chief Executive and Registrar £255,000 – £260,000
Anthony Omo Director of Fitness to Practise £205,000 – £210,000
Una Lane Director of Registration and Revalidation £205,000 – £210,000
Neil Roberts Director of Resources and Quality Assurance £205,000 – £210,000
Shaun Gallagher Director of Strategy and Policy £205,000 – £210,000
Colin Melville Medical Director and Director of Education and Standards £205,000 – £210,000
Paul Reynolds Director of Strategic Communications and Engagement £205,000 – £210,000

Honest Fromyorkshire 16 November, 2022 5:29 pm

I suggest they worry more about those of us who pack in early and leave medicine for good. It isn’t exactly rocket science to work out that if your workforce is just walking away the job must be rubbish.

Scottish GP 16 November, 2022 10:25 pm

Risable, got a mirror Charlie?, perhaps you don’t have a reflection

Christopher Jones 16 November, 2022 11:09 pm

Surely we can think of one organisation in particular who have gone above and beyond the call of duty in their single-minded and highly successful efforts to make working in the profession intolerable?

David Banner 17 November, 2022 9:42 am

The reason why General Practice worked remarkably well for so many years was the Partnership Model. A job for life, well paid, almost totally independent, master of your own destiny. 30+ years then pass the torch on to a willing young replacement. Brilliant for both doctors and patients

But the rest of the NHS detested our Splendid Isolation, and have spent decades undermining the Partnership Model, exposing its Achilles Heel, namely that without succession it rapidly falls apart, as partners scramble for the exit to avoid Last Man Standing unlimited liability.

Now we have a hodgepodge of dwindling partnerships, floating locums and exploited salaried GPs, all under constant scrutiny in a rigged system with unlimited workload and a hostile public/media/government.

So those who are able will emigrate to where they are appreciated, whilst the rest either retire early or diversify to avoid the frontline trenches.

And yet the architects of this downfall won’t admit their failure. They bus in the SAS doctors whilst telling the rest of us to “roll up our sleeves”, instead of reversing the unmitigated disaster of over regulation and unlimited workload.

We’ve been howling into the wind for decades about GMC, QOF, CQC, PCNs et al, yet these yokes on our necks continue to multiply. Dismantle these impediments and maybe, just maybe, you can reverse the seemingly terminal decline in General Practice. But if you carry on regardless, don’t complain when the whole system collapses around you.

Turn out The Lights 17 November, 2022 11:22 am

Spot on DB.

Gabor Szekely 17 November, 2022 12:54 pm

Never a truer word.

Dave Haddock 17 November, 2022 4:37 pm

More sense from DB than any of our current “leaders”.

Centreground Centreground 17 November, 2022 6:43 pm

One of my children due to travel overseas in next month and i will encourage the other 2 to try this once they qualify over next few years – if they decide to leave UK permanently I will also complete my last 5 years overseas as a working holiday – Why have all this nonsense with PCNs, CQC, GMC , ICBs etc etc etc and all the negative press?

Peter Frost 17 November, 2022 9:38 pm

We’ve lost two partners to Australia.
I think the reasons have been covered …
I’ve just spent another afternoon of online “Bluestream Training” on clinical governance, manual handling, hand washing etc etc”. We’ve all got to do this and more…. stupid bureaucratic exercises so some CQC or GMC bullshit box can be ticked. How many appointments are lost to this sort of rubbish alone.
Our management team are now supported by a GP to cope with the increasingly pathetic entitled , “ trip advisor “ type complaints that roll in.
If we were free from the endless political meddling the job and the service for patients could be improved overnight.

Coalface Slave 17 November, 2022 11:23 pm

Hmm …. start with changing the culture, its simply plain nasty, stressful and horrible.

Flatten NHS management, put all the nurse managers back working with patients.

Don’t have non doctors manage doctors.
Bring back the hospital matron and a doctor superintendent.

Adopt New Zealand’s no blame culture.

Bounce all complaints back to source (exception gross clinical negligence), especially all the interpersonal stuff, people are really are not perfect ever.

Change GP entry requirements for currently registered and licenced doctors with 5 years experience.

Keep the exams but scrap the UK fy2 equivalence for anyone with GMC liscenced registration, we are all doing the job anyway.

Put SAS docs and other liscenced registered docs on decently paid GP apprenticeships with a tier system retaining the exam for full RCGP Membership

John Charlton 19 November, 2022 11:31 am

Many good points. As of Thursday retention just a whole lot worse. Just back from New Zealand. Sadly for the NHS there are wonderful career – family life openings.

Truth Finder 21 November, 2022 5:55 pm

Hypocrite. Start by reforming the GMC which is one of the big reasons people leave. We should never have allowed a non practicing medic to head a professional organization. He is not even qualified in medicine. Less doctors? They should all take a pay cut! C’mon BMA start a new organization, the GMC has lost the profession’s confidence and is unfit for purpose.

Anonymous 14 March, 2023 11:22 am

Reform GMC now. Fire all nonclinicians. Reduce fees by half. Make it truly nonprofit with all surplus returned to members.