Guidelines in Practice readers shared their views on workforce, workload, primary care network development, and the future of primary care


A recent survey conducted by Guidelines in Practice to explore the state of general practice has discovered significant problems with staffing, workload, and primary care network (PCN) integration, and suggests that more challenges than opportunities lie ahead for primary care.

Workforce and workload

Primary care is under unprecedented pressure, and many practices are beset by recurring problems such as workforce shortages and staff burnout. Of the survey respondents:

  • 64% reported unfilled posts in their practice team
  • 84.9% said that these vacancies are negatively affecting patient care, and 89.7% that they are impacting team morale
  • 80% (87.6% of doctors) considered their workload heavier than normal, and 25.6% (41.6% of doctors) said that it is unmanageable
  • 47% (49.1% of doctors) stated that they plan to change role within the next 2 years.

In addition, the participants reported that measures intended to mitigate excessive workloads, such as digital triage and remote consultations, are not doing enough to lighten the burden on primary care staff.

Primary care network development

Despite agreeing that their practices were able to fulfil the requirements of the PCN Directed Enhanced Service (DES), many respondents identified workforce shortages and the backlog of care created by the pandemic as the biggest barriers to achieving PCN DES requirements. 

Furthermore, the responses revealed a degree of frustration about the failure of PCNs to improve core aspects of patient care. More than half of those surveyed believed that meeting PCN DES requirements is an obstacle to providing other services, and 67.2% thought that the introduction of additional service specifications should be delayed.

The future of primary care

In addition to staff shortages (76.7%) and the care backlog (66.1%), the respondents identified burnout (79.2%) and insufficient funding (60.9%) as the greatest challenges in general practice today. Other hurdles reported by participants include low morale, poor communication, and fragmented care.

The respondents did identify some opportunities: the most commonly reported prospect for primary care was the potential to increase the skill mix of the primary care team (58.5%), followed by benefits associated with the use of social prescribers (48.9%).

However, what is clear from the responses is that, without urgent intervention to tackle the workforce shortfall and excessive workloads in primary care, no amount of restructuring within the NHS will improve the situation for healthcare practitioners in primary care or their patients.

Editor’s comment

Reacting to the survey’s findings, Nina Buchan PhD, Editor of Guidelines in Practice, said: ’The results of our readership survey reflect the impact of staff shortages on both healthcare professionals working in primary care and their patients. At the same time, many respondents report that measures designed to relieve the unsustainable workloads faced by members of the multidisciplinary primary care team are failing to do so, likely compounding the effect of inadequate staffing. In addition, the majority of those surveyed identify workforce shortages as the biggest barrier to implementing the requirements of the PCN DES. It is clear from the responses that urgent action is required to resolve the shortage of staff in primary care.’

Read an article summarising the survey results at:

A full report of the survey’s findings will be published online later in 2022.

Lead image: wutzkoh/
Image 1: wutzkoh/