UK GPs suffering unsustainable workplace pressures

UK GPs experience the highest stress and lowest job satisfaction compared to GPs in 9 other high-income countries, according to new analysis of Commonwealth Fund data from the Health Foundation. Just a decade earlier UK GPs were among the most satisfied of any country.

A new Health Foundation report paints a grim picture of the pressures facing GPs in the UK and internationally. The report analyses data from an international survey of 9,526 GPs in 10 high-income countries, including 1,010 in the UK, carried out by the US-based foundation, the Commonwealth Fund. A majority of GPs in all countries are dealing with higher workloads than before the pandemic – and many have experienced greater stress and signs of emotional distress.

But UK GPs report higher levels of emotional distress and bigger rises in workload than GPs in nearly all other countries, with many considering leaving the profession altogether. 71% of UK GPs find their job ‘extremely’ or ‘very stressful’, the highest of the ten countries surveyed alongside Germany. Stress among UK GPs is up 11 percentage points since 2019.

GPs in the UK are among the least satisfied with practising medicine, with just 24% of UK GPs ‘extremely’ or ‘very’ satisfied – similar to GPs in France but lower than all other countries. UK GPs are also among the least satisfied with their work-life balance, workload, and time spent with patients compared to GPs in the other countries surveyed. UK GPs think patient care has suffered compared with before the pandemic, with half believing the quality of care they can provide has worsened and only 14% thinking it has improved.

The survey also illustrates some of the core strengths of general practice in the UK, including a high proportion of GPs feeling well-prepared to manage care for patients with long-term conditions and mental health needs. UK GPs are more confident in managing palliative care needs (96%) and dementia (95%) than in most other countries. The UK also performs well on online access to services, using electronic medical records, and use of data to inform care.

Despite repeated government pledges to increase the number of GPs, the number of fully qualified, full-time equivalent GPs in England has fallen since 2015. GP shortages are estimated at 4,200 and could grow to 8,800 by 2031 – around 1 in 4 of projected GP posts. The government's forthcoming NHS workforce plan and General Practice access recovery plan must meaningfully address these challenges to secure a sustainable future for general practice and the patients it serves.

Hugh Alderwick, Director of Policy at the Health Foundation, said: "The NHS is not the only health system under pressure, but the experience of GPs in the UK should ring alarm bells for government. General practice is the foundation of the NHS, yet GPs are telling us loud and clear that these foundations are creaking.

"The pandemic has taken a heavy toll on UK GPs, combined with longer-run challenges including staff gaps and rising workload. Just a decade ago, UK GPs were among the most satisfied of any country in the survey, but now they are the least satisfied alongside GPs in France. GPs are stressed out and burnt out – and many are considering leaving their jobs.

"Decisive policy action is needed to improve the working lives of GPs – including to boost GP capacity, reduce workload, and make use of wider primary care staff.  The government has promised that its much-delayed workforce plan for the NHS will be published shortly, but the promise of new doctors will be little good if the NHS cannot retain the ones it already has.”

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