The latest edition of the official GP Worklife Survey has painted a dire picture of the realities of working as a GP in England.
Among the most alarming findings, the University of Manchester research – carried out every other year on behalf of the Department of Health and Social Care – reveals that over a third of GPs in England may likely quit direct patient care within five years.
The 11th biennial GP Worklife Survey, conducted between December 2020 and December 2021, received responses from 2,227 GPs across England.
The national survey, funded by the National Institute for Health Research (NIHR), crucially informs the DHSC’s evidence to the Doctors’ and Dentists’ Pay Review Body.
The 2021 results, published today, show that over a third (33.4%) of GPs said there was a ‘considerable or high likelihood’ of them leaving ‘direct patient care’ within five years.
For those aged 50 and above, this figure rose to 60.5%, with the overwhelming majority of these (47.1%) saying the likelihood was high.
The proportion of GPs under 50 with a ‘considerable or high’ desire to leave direct patient care within five years is at its highest level of 15.5% compared to previous surveys.
However, 43.2% of GPs under 50 said there was ‘no chance’ of them resigning in the next five years.
The study also found:
- The mean level of overall satisfaction dropped significantly from 4.49 in 2019 to 4.3 in 2021.
- GPs indicated least satisfaction with their hours of work, with 46.7% saying they are dissatisfied.
- A ‘statistically significant decrease’ in the number of hours worked, dropping from 40 hours in 2019 to 38.4 hours in 2021. This is the second consecutive survey with ‘substantial decreases’ in mean hours worked, which is ‘notable’ as there was ‘very little survey-to-survey variation’ between 2008 and 2017.
- The top job stressors included increasing workloads, increased demands from patients, having ‘insufficient time to do the job justice’, paperwork (including electronic), long working hours.
- Changes to meet requirements from external bodies such as the CQC and NHS England, as well as ‘unrealistically high’ expectations of the role by others also scored highly.
- GPs reported the least stress sourcing a locum and completing patient forms such as fit notes.
- More than eight out of 10 GPs said they were experiencing ‘considerable or high pressure’ from larger workloads and increased demands from patients.
- Average levels of pressures have declined between 2019 and 2021 in all aspects apart from ‘adverse publicity by the media’, ‘dealing with problem patients’ and ‘increased demands from patients’.
- And all average reported pressures remain at ‘a relatively high level compared with earlier surveys’.
- For job attributes, respondents were most likely to agree with the statements:
- ‘the patients I see are presenting with increasingly complex care needs’ (96.5%)
- ‘I have to work very intensively’ (94.5%)
- ‘I have to work very fast’ (87.2%)
Study leader and GP Dr Kath Checkland said: ‘It is not really surprising that job satisfaction has dropped amongst GPs during the pandemic, but the survey provides some evidence about the areas of work they are finding more stressful, which may help in designing ways to support them.
‘The fact that 16% of GPs under the age of 50 are thinking about leaving their jobs is worrying, and suggests that work is still needed to ensure that general practice is sustainable for the long term.’
BMA England GP committee executive officer and GP Dr Richard Van Mellaerts said that if 60.5% of GPs over 50 do quit, ‘this will represent a huge loss to the NHS and patients of highly skilled and experienced GPs’.
He said: ‘GPs and their teams are exhausted from the pandemic, struggling with a toxic combination of escalating patient demand at the same time as the number of fully qualified, full-time GPs has fallen significantly.’
He added that the survey also shows ‘the notion of a “part-time” GP is often anything but’, as the average 38.4 working hours per week of a GP in England is ‘similar to most full-time jobs’.
RCGP chair Professor Martin Marshall remarked that the findings ‘show a profession working under intense workload and workforce pressures, doing their best for patients in the most difficult of circumstances’.
He added: ‘It’s concerning to see any GP leaving the profession earlier than they planned, particularly in such high numbers, but it’s especially worrying to see so many family doctors planning to leave relatively early in their careers.
‘This should be a wake-up call that we need to see robust plans implemented to retain highly-trained, experienced GPs in the workforce – and key to this will be tackling workload.’
The most recent GP Worklife Survey, conducted in 2019, found that GPs were working on average two hours per week less than in 2017.