Retention as vital as recruitment in addressing GP workforce crisis

As reported by the Royal College General Practitioners, urgent action must be taken to keep GPs in the profession

Urgent action must be taken to keep highly-trained and experienced GPs in the NHS workforce delivering patient care, the Royal College of GPs is warning today.

Launching its new report: Fit for the Future: Retaining the GP Workforce, the College makes the case that retaining the existing workforce should be seen as big a priority as recruiting new GPs.

It highlights that high levels of stress and burnout, pension rules, family and caring responsibilities, and recruitment issues, particularly in deprived areas, are all key factors associated with GPs deciding to leave the profession earlier than planned.

To coincide with the report’s publication, the College has identified areas of England where only small numbers of GPs are registered on existing national retention schemes despite seeing a significant drop in GP numbers. National retention schemes are designed to offer support to GPs on the verge of leaving the profession in order to keep them in general practice delivering patient care for longer.

Two of the worst affected are South Yorkshire, which currently has only six GPs on the national retention scheme, despite losing 187 GPs and trainees between June 2019 and June 2022, and Manchester, also with just six GPs on the scheme, despite 117 GPs and trainees leaving over the last three years.

The College is calling for an evaluation and expansion of existing national and local retention schemes in England, backed by £150m a year, to ensure take-up is maximised and their potential to bolster the GP workforce is not missed. Barriers identified in the report include limited funding to sustain or set up new initiatives, difficulties in accessing schemes and a lack of awareness of schemes amongst some GPs.

The College’s calls for urgent action to retain GPs in the profession come at a time when GPs and their teams are working under intense workload and workforce pressures, further exacerbated by the pandemic.

Across England, the number of fully qualified, full-time equivalent GPs fell from 29,364 in September 2015 to 27,515 in August 2022, a drop of 1849. In 2021, GPs and their teams delivered almost 370m patient consultations, up 18.5% from 2019, and as of August this year, each GP in England is on average looking after 15% more patients than in 2015.

Workforce shortages are predicted to worsen, with a recent RCGP survey revealing almost 22,000 GPs and trainees across the UK plan to leave over the next five years. While significant progress has been made to boost recruitment into general practice, with more GPs currently in training than ever before, this will not be enough to counter the numbers planning to leave the profession.

Action to improve retention in general practice will be vital to addressing the immediate and long-term workforce crisis. The College is calling for:

• A comprehensive review of existing retention initiatives in England, backed by an investment of £150m per year to:
  • Develop local retention initiatives in every locality so that every GP can access tailored support to stay in the profession longer.
  • Ensure funding is available in every locality for GPs to access a national retention scheme.
• An evaluation of and improvements to induction and career support programmes for early career GPs.
• Action to address unsustainable GP workload including cutting unnecessary bureaucracy and expanding multidisciplinary teams to free up GPs’ time for patients who need medical care.
• Development of effective communications for patients that explain the role of the GP and other members of the team to help patients navigate general practice.

Professor Martin Marshall, chair of the Royal College of GPs, said: “GPs and our teams are working under intense workload and workforce pressures and this is, unfortunately, impacting on the care and services we’re able to deliver to patients.

“GPs are leaving the workforce at all stages in their career, with many citing exhaustion and burnout as their reasons for leaving. Indeed, a recent RCGP survey suggested almost a quarter of GPs across the UK were so stressed that they felt they couldn’t cope most days or every day. This isn’t just impacting GPs but their patients too, with over 68% of respondents of the same survey expressing concerns they don’t have enough time to properly assess their patients. While there has been good progress to encourage newly qualified doctors into the profession, if more GPs are leaving than joining, we’re fighting a losing battle. We’re stuck in a vicious cycle of an understaffed and under-resourced service that is unable to sustainably meet the needs of its patients.

“Urgent action is needed to break this cycle. The Government must make GP retention a priority. We need to see properly funded and revamped retention strategies at national and regional levels, that offer GPs the support they need at all stages of their career. We also need to see action to address a key cause of poor retention: unsustainable workload. We want to see the job made more ‘doable’ by cutting the huge amount of red tape GPs have to complete, which takes them away from delivering patient care.

“Being a GP is a fantastic, stimulating and professionally satisfying career when it is adequately resourced and when we have the time to deliver the care our patients need. GPs need support to keep them where they want to be: delivering good, safe, timely and appropriate patient care.”