Excessive workload forcing GPs to quit, RCGP survey shows

An RCGP survey has highlighted exactly how overworked and under pressure UK GPs are

The Royal College of General Practitioners (RCGP) has surveyed 1,096 GPs in the UK, and found that more effort must be poured into reducing their workload to avoid them abandoning their posts.

The survey found that:

• 31% of GPs said they are unlikely to be working in general practice in five years with stress and retirement cited as the main reasons for this.
• Five per cent of GPs* report that their practice is likely to close in the next year. These are not practices that are merging with others.
• 37% of GPs* said that in the practice where they work, there are GP vacancies that have been open for more than three months.

The RCGP also analysed the latest provisional workforce data from NHS Digital for September 2018, which showed an increase of 41 from September 2017**. However, looking back to September 2015, the total number has dropped by 460.

Taking the data at CCG-level, the College has identified where in the country has seen the biggest increase in GP numbers – with one area seeing an extra 87 GPs since September 2015 – and where has seen the biggest decrease.

Areas with biggest increases in GP numbers between Sept 2015-Sept 2018:

• NHS Liverpool CCG (87)

• NHS Northern, Eastern and Western Devon CCG (67)

• NHS Kernow CCG (54)

• NHS Lambeth CCG (45)

• NHS Gloucestershire CCG (41)

Areas with biggest decreases in GP numbers between Sept 2015-Sept 2018:

• NHS Horsham and Mid Sussex CCG (-52)

• NHS Walsall CCG (-33)

• NHS Portsmouth CCG (-29)

• NHS Hull CCG (-22)

• NHS Thanet CCG (-19)

The College says that a primary factor in GPs leaving the workforce prematurely is excessive workload; as a result, GP numbers are lower than they were three years ago.

Last month the College renewed its long-standing calls for general practice to receive 11% of the overall NHS budget as part of the forthcoming 10-year plan for the NHS.

Professor Helen Stokes-Lampard, chair of the RCGP, said: “All GPs are overworked, many are stressed, and some are making themselves seriously ill working hours that are simply unsafe, for both themselves and their patients – it is making them want to leave the profession. It is forcing some GPs to hand back their keys and close their surgeries for good.

“This is having a serious impact on many of our patients, who are waiting longer and longer to secure a GP appointment. But it also means we don’t have the time we need with patients – particularly the growing number living with multiple, complex conditions – so the standard 10-minute appointment is simply unfit for purpose.

“GPs often find ourselves fire-fighting by prioritising the urgent cases, whereas the strength of general practice is to prevent disease and identify conditions in the early stages, to avoid them becoming more serious – and costlier to the health service.

“About a third of the GPs we surveyed said they were unlikely to be working in general practice in five years’ time. This is gravely concerning. We are talking about highly-trained, highly-skilled doctors, that the NHS is at risk of losing – some will retire, which is to be expected, but many are planning to leave earlier than they otherwise would have done because of stress and the intense pressures they face on a day to day basis, whilst simply trying to do their best for their patients.

“These GPs are the ones we need to be focussing our energy on – to make their working situation safer and more sustainable.

“NHS England and Health Education England have done excellent work, supported by the RCGP and others, to encourage more doctors to specialise in general practice and we now have more GPs in training than ever before. But GP specialty-training takes three years, and if as many GPs are leaving the profession as entering it, we are fighting an uphill battle, when realistically we need thousands more.

“We need to see this level of effort replicated in initiatives to retain GPs already in the profession, to reduce our escalating and often unnecessary workload, and to support GPs and our teams’ own health and wellbeing.

“The RCGP is calling for general practice to receive 11% of the overall NHS budget as part of the forthcoming 10-year plan for the NHS. Investing in general practice is investing in the entire NHS. It is an investment in good patient care.”

Responding to the survey, BMA GP committee chair, Dr Richard Vautrey, added: “These findings are alarming and will cause a great deal of worry for patients who would be forced to find a new practice. While GPs strive to provide high quality care to all of their patients, statistics such as this speak volumes to the huge amount of pressure they are under; rising demand from a growing population with increasingly complex conditions means that workload is nearing insurmountable levels.

“Given the stress this causes and impact that it has on doctors’ wellbeing, it is unsurprising that many are questioning their own futures and the future of their practices.

“For the last 70 years general practice has been the foundation on which the NHS is built, but without proper support, investment and a plan to tackle the current retention crisis, it is in serious risks of crumbling.

“The BMA is therefore urging the government, using its long-term plan, to drastically increase the share of the NHS budget that general practice receives to guarantee its ability to continue to provide high-quality, person-based care from within the community for years to come.”

*GPs who do not work only in out of hours services
**All practitioners, including GP registrars, retainers and locums

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