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Only a quarter of GP trainees plan to work full-time

Intense workload main reason trainees chose part-time work

Adrian O'Dowd

Monday, 02 December 2019

Only around a quarter of GP trainees say they plan to work full time in general practice a year after they have qualified, according to a new survey published at the weekend.

Think tank The King’s Fund published the findings of The future of general practice: the views of GP trainees which included the views from a survey of 840 GP trainees across England.

The number of doctors entering GP training is higher than ever, yet the overall number of full-time equivalent GPs keeps decreasing as shown last week in figures from NHS Digital* that revealed the full-time GP headcount fell by 340 in post compared with this time last year.

The latest GP workforce figures showed there was a 2% drop in the number of permanent, full-time equivalent GPs in the past year and 6.2% fewer in September 2019 than in 2015.

In the new survey, The King’s Fund found that only 27% of trainees intended to work full time in general practice one year after qualifying and only 5% after 10 years – which is down from 31% and 10% in the equivalent 2016 survey.

The most common reason given for choosing to work part-time or portfolio work was the intensity of the working day – cited by 69% of respondents – although family commitments (66%) and interest in other work such as emergency medicine or palliative care (50%) were also important factors.

One unidentified respondent said: “Patient volume and work intensity makes a nine-session week look intolerable in terms of risk of burn-out and maintaining a decent standard of care.”

Other NHS clinical work or medical education were also common choices to combine with general practice as a portfolio career.

Less than half (41%) of respondents said they were considering GP partnership at 10 years – down from 45% in 2016 – and the most common reasons for this were the financial implications (58%) and the lack of training in business matters (47%).

The King’s Fund said the falling numbers of full time equivalent GPs was one of the reasons that patients reported increasing dissatisfaction with their ability to access general practice, although they were satisfied with their care once they were seen.

Beccy Baird, senior fellow at The King’s Fund and expert on primary care, said: “Given it is likely that many new GPs will spend only part of their working week in general practice, promises of 5,000 or 6,000 more full time equivalent GPs will mean finding many more individual GPs, potentially as much as half as many again.

“There appears to be a political arms race for who can set the highest target for recruiting new GPs, but unless the next government addresses the unsustainable workloads that cause GPs to leave or reduce their hours, those aims may fast become broken promises.”

Dr Richard Vautrey, chair of the GP committee at the British Medical Association, told OnMedica: “With GP workload soaring, it’s unsurprising that trainees are taking a more flexible approach to working, in the hope of regaining a work-life balance and making sure they remain safe to practise.

“Regardless of their working patterns though, being a GP in the NHS right now is tough and practices across the country are struggling to keep up with increasing patient demand.

“That’s why we need urgent investment and workload management initiatives to ensure that general practice is a better place to work, and we continue to recruit as many family doctors as possible by offering flexible opportunities in order to provide the high-quality care our patients need and deserve.”

*NHS Digital. General Practice Workforce 30 September 2019 (28 November 2019).

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