Health Professions February 28, 2019
40 per cent of GPs to quit within next five years

By News Feature - Accountable Care Journal

A new survey from the University of Warwick has revealed that over 40 per cent of GPs intend to quit general practice over within the next five years.

The survey of 929 GPs in the Wessex region, published in BMJ Open, revealed that recent national NHS initiatives are failing to address unmanageable workloads for GPs. The results show that 42.1 per cent of GPs intend to leave or retire from NHS general practice within the next five years compared to 31.8 per cent of those surveyed in the same region in 2014, an increase of almost a third.

Over half of those surveyed reported that they were working longer hours than in 2014, with 'workload' being identified as the most significant issue. This comes alongside worsening morale, another driver to GPs looking for early retirement.

The lead author, Professor Jeremy Dale, from Warwick Medical School, highlighted the worry that the number of GPs looking to leave is increasing, despite "a number of NHS measures and initiatives that had been put in place to address this over the last few years."

“Intensity of workload, and volume of workload were the two issues that were most closely linked to intentions to leave general practice, followed by too much time being spent on unimportant bureaucratic and administrative tasks," he added.

Many GPs clearly feel that this is ‘too little, too late’

- Professor Jeremy Dale

Analysing the findings, the British Medical Association (BMA) reflected on the 'critical time' for general practice, due to almost one in every two GPs being over the age of 45.

Staff pressures are not localised 

Workload issues are strongly linked to the size of the general practice workforce not keeping pace with growing demand for primary care services. This is primarily fuelled by increasing numbers of patients with complex long-term conditions such as diabetes, hypertension and stroke, as well as multi-morbidity with patients reporting more than one condition. England's increasingly ageing population adds further to the pressures in the sector as older patients are more likely to use primary care services and struggling social care is failing when it comes to prevention.

Reform and integrate 

The NHS Long Term Plan set out a roadmap to increase investment and support in primary care, cut bureaucracy and develop new integrated care systems that better encompass primary services into the wider healthcare system. This is alongside the promise of an additional 22,000 new allied health professionals to support GPs and a funding boost for primary care. While promising, not all proposed reforms are supported by GPs. The survey revealed that many have a negative view of technological innovations such as video consultations.

Reforms outlined in the Long Term Plan have been 'copper-fastened' in the new GP contract, says the BMA, which expects improvements to begin to appear as a result of the extra investment. While being optimistic about the distant future, urgent changes need to occur in the short-term if reforms are to be effective and the looming crisis is to be averted.

Commenting on the results, Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: “The NHS long-term plan has aspirations that will be good for patients - but we will need the workforce to deliver it." Looking ahead to the forthcoming NHS workforce strategy for England, she called for measures to make general practice more sustainable by 'reducing workload' and 'removing incentives' for GPs to retire early.

#ACJ #ACJPrimary