One-third of GPs in England could leave their roles within the next 5 years, survey results have revealed

A stressed male doctor with his head on his hands behind a pile of work.

Increasing workload, patient demands, and insufficient time to do their job were cited as stressful factors that could influence their decision, according to the Eleventh National GP Worklife Survey, published today.

The Royal College of General Practitioners (RCGP) described the findings as ‘a wakeup call’ to tackle the workload faced by general practice and ensure that the profession retained experienced doctors.

Responses were received from 2277 GPs from across England between December 2020 and December 2021 during the unprecedented conditions caused by the COVID-19 pandemic that brought about dramatic changes in practice working conditions.

GPs considering their future

The survey by the University of Manchester on behalf of the Department of Health and Social Care found that 33.4% of respondents said there was a ‘considerable’ or ‘high’ likelihood of them leaving direct patient care within 5 years. That figure was considerably higher at 60.5% among GPs aged 50 years and over, with 47.1% of those indicating that the likelihood was high. The percentage of older GPs who expressed a considerable or high intention to quit was lower than 2019, and at its lowest level since 2015.

Among the under 50s, only 15.5% said they were considering leaving practice, with 43.2% of those stating there was no chance of them leaving direct patient care within the next 5 years. However, the proportion who had a considerable or high intention to leave direct patient care within 5 years had increased since 2019 and was at its highest level compared to previous surveys.

Stress in the workplace

GPs were asked to rate 17 factors according to how much pressure they experienced from each in their job on a five-point scale, ranging from no pressure to high pressure.

Increasing workloads ranked highest, reported by 86.3% of GPs, followed by increased demands from patients (84%), and having insufficient time to do justice to the job (79.5%). Paperwork, including electronic administrative tasks, long working hours, and dealing with problem patients, also ranked highly.

Finding a locum was ranked as the least stressful aspect of factors listed, as were doing patient forms, such as fit notes and blue badges.

Average reported pressures were found to have decreased between 2019 and 2021, except for ‘adverse publicity by the media’, ‘dealing with problem patients’, and ‘increased demand from patients’. However, pressures remained at a relatively high level compared with previous surveys, the researchers said.

Stress caused by changes to meet requirements from external bodies, such as the Care Quality Commission, NHS England, and CCGs, were in the top five stressors in previous surveys, but ranked seventh in the latest, mentioned by 67.8% of GPs.

Job satisfaction

The mean level of overall job satisfaction declined by a statistically significant amount from 4.5% in 2019 to 4.3%. Respondents indicated that their fellow workers and their physical working conditions were the most satisfying features of their job.

The least satisfaction was reported for their working hours, while recognition for their work as well as pay also ranked low down the list.

The survey of GPs’ working lives has been conducted approximately every 2 years since 1998. Invitations for the latest survey differed from preceding field work in the latest study as they were sent electronically, rather than by post, to a random selection. To check for anomalies, the research team also randomly sampled 2284 GPs via paper questionnaires.

‘Worrying’ findings

Commenting on the survey, Professor Martin Marshall, Chair of the RCGP, said: ‘These findings, which reflect those of surveys we have conducted of members, show a profession working under intense workload and workforce pressures, doing their best for patients in the most difficult of circumstances.

‘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.’

Dr Richard Van Mellaerts, England GP Committee Executive Officer at the British Medical Association, said the percentage of GPs likely to quit direct patient care‘highlights the extent of the staffing crisis facing general practice’.

He said that staff were ‘exhausted from the pandemic’ and ‘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:‘The Government must now come forward and work with the profession to fix the problems which are leading doctors to leave the NHS. Without doing so, we face a mass exodus of GPs, which will put patient care in serious jeopardy, all at a time when we need our health service more than ever before.’

The survey was funded by the National Institute for Health Research.

This article originally appeared on Medscape, part of the Medscape Professional Network.

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