Recent initiatives to improve GP retention might be having an impact on specific targeted areas but most GPs are experiencing little effect – more than half plan to leave the profession within the next five years, a new report* from the Wessex region revealed this morning. Its authors called for more urgent action to stem the growing workforce crisis in general practice.
A team from Warwick Medical School in Coventry conducted the first survey to report GPs’ views and experience of national initiatives that have been introduced in England to address the workforce crisis in general practice, looking at the GPs’ intention to remain working as GPs. They chose Wessex because a similar survey was conducted in the region in 2014, so they could analyse how views were changing over time; BMJ Open has published their results.
They pointed out that although in 2015 the government committed to creating 5,000 additional GP posts by 2020, recent figures have suggested that a further deficit of 1,300 full-time equivalent GPs has developed – reflecting a pattern of falling recruitment to GP specialist training and increasing numbers of GPs leaving to work abroad, take career breaks, work part-time or retire early.
They asked all 1,697 GPs in the Wessex region qualitative and quantitative questions in an online questionnaire survey, and more than half (54.7%) participated.
Among the 929 respondents, 59.4% said morale had reduced over the past two years, and 48.5% said they had brought forward their plans to leave general practice. Reported intention to leave/retire from the profession in the next two years increased from 13% in the 2014 survey to 18% in October/November 2017, and intention to continue working for at least the next five years plummeted from 63.9% to 48.5% over that period. GPs’ stated intention to leave was associated with their age, length of service and lower job satisfaction. The most common reasons that GPs gave for intending to leave sooner than they’d previously planned were work intensity and amount; 51.0% participants said they were working more hours than they had been two years previously, predominantly because of increased workload.
The researchers also asked GPs what might help to improve retention, and for their opinions on national initiatives designed to do so. Respondents suggested that increased funding, more GPs, better education of the public and expanding non-clinical and support staff could improve retention, and reported positive views of national initiatives aligned with these priorities, for example funding to expand practice nursing – but few said they’d seen evidence of this being rolled out. They generally reported negative views of national initiatives that did not align with those priorities, such as video consulting.
The report’s authors commented: “While recent initiatives may be having an impact on targeted areas, most GPs are experiencing little effect. This may be contributing to further lowering of morale and bringing forward intentions to leave. More urgent action appears to be needed to stem the growing workforce crisis.”
Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: “GPs are under intense strain – our workload has escalated in recent years, both in terms of volume and complexity, but we have fewer GPs than we did two years ago.
“There is some great work ongoing to increase recruitment into general practice, and we now have more GPs in training than ever before – but when more family doctors are leaving the profession than entering it we are fighting a losing battle.
“The NHS long-term plan has aspirations that will be good for patients – but we will need the workforce to deliver it. The forthcoming NHS workforce strategy for England must contain measures to help retain GPs in the workforce for longer – steps to reduce workload to make working in general practice more sustainable and removing incentives to retire early for GPs who might not necessarily want to would both be sensible places to start.”
*Owen K, Hopkins T, Shortland T, Dale J. GP retention in the UK: a worsening crisis. Findings from a cross-sectional survey. BMJ Open 2019; 9: e026048. doi: 10.1136/bmjopen-2018-026048.