UK GPs are the least satisfied with appointment times

Author: Louise Prime

GPs in the UK are the least satisfied with the time they have with patients out of 11 high-income countries, The Health Foundation has reported. It also found that UK GPs are overwhelmingly dissatisfied with their workload and report high stress levels.

The Health Foundation has published Feeling the strain, its UK-focused analysis of an international survey of 13,200 GPs from 11 high-income countries, including 1,001 UK GPs, undertaken by the Commonwealth Fund between January and June 2019. This found that in some aspects of care, the UK performs strongly and is an international leader: almost all UK GPs surveyed use electronic medical records; use of data to review and improve care is relatively high; and they are also broadly supportive of policymakers’ ambitions to improve integration of services.

But the charity’s analysis also revealed that just 6% of UK GPs report feeling ‘extremely’ or ‘very satisfied’ with their workload – the lowest of any country surveyed. Only France has lower overall GP satisfaction with practising medicine. GPs in the UK also report high stress levels, and feel that the quality of care that they and the wider NHS can provide is declining. It noted that despite a 2015 target for 5,000 additional GPs by 2020, there are now 1,700 fewer qualified permanent GPs than in 2015; and the number of patients per GP has grown, from 2,180 to 2,240 last year alone, placing greater workload on practitioners. UK GPs reported doing more of most types of patient consultation, including face to face, telephone triage and telephone consulting.

The survey revealed that a high proportion of surveyed UK GPs plan to quit or reduce their working hours in the near future. 49% of UK GP respondents plan to reduce their weekly clinical hours in the next three years (and 10% plan to increase them).

And, it found, UK GPs continue to report shorter appointment lengths than most of their international colleagues – a mean of 11 minutes, compared with 19 minutes in the other countries surveyed. UK GPs are the least satisfied with the amount of time they are able to spend with patients – just one in four UK GPs (29%) feel satisfied with the length of time spent with patients, and only 5% feel ‘extremely’ or ‘very’ satisfied, significantly lower than the satisfaction reported by GPs in the other 10 countries surveyed.

The report’s authors make several recommendations for policymakers in England:

  • Do more to understand what would keep GPs in practice, with solutions rapidly implemented. The measures that have been tried so far are not turning the tide on GPs’ intentions to reduce their hours or leave practice altogether. 
  • Enable GPs to offer longer appointment times. This is particularly difficult in the face of rising patient need and falling GP numbers; however, GPs with longer appointment times report greater job satisfaction. 
  • Improve the speed of communication with hospitals. Although the UK performs reasonably well in terms of sharing clinical information between practices and hospitals, GPs report that these processes are often too slow. 
  • Put in place realistic ambitions for digitally enabled primary care. The survey findings show that most GPs in the UK are a long way from meeting ambitious targets set by government to offer digital services to patients.

One of the report’s authors Dr Rebecca Fisher, a GP, said: “This survey shows that over the long-term we need concerted action to stabilise general practice. Despite performing strongly in some aspects of care, many GPs consider that appointments are simply too short to fully meet the needs of patients. Too many GPs are highly stressed and overburdened – to the point of wanting to leave the profession altogether.

“Policymakers need to be sure not to build castles on quicksand. Primary care networks are intended to reform general practice, but solutions that rely on the existing GP workforce doing more are likely to misfire. Bringing in additional workforce, from pharmacists to physios, is welcome but will not quickly solve the immediate pressures facing GPs.”

The Royal College of GPs said it is “incredibly concerning” that UK GPs are more dissatisfied with the job, on many levels, than family doctors in other countries. College vice-chair Dr Gary Howsam said: “Being a GP can be the best job in the world and we currently have more GPs in training that ever before – but unless significant steps are taken to make working in general practice more sustainable for existing GPs, they will burn out and leave the profession earlier than planned, and that will benefit nobody…

“Standard 10-minute consultations are rarely appropriate to deliver the complex, high-quality care our patients deserve. We often find ourselves trying to cram far too much into 10 minutes, not only trying to deliver holistic care, but fitting in the increasing number of things we are expected to do during a consultation. No GP wants to hurry an appointment, and the result of having to doing so is stressful and dissatisfying for the GP and can leave patients feeling as though they have been rushed.”