The ‘gravely concerning’ RCGP survey of over 1,000 GPs found that nearly a third (31%) of respondents said they were likely to leave the general practice workforce within the next five years - citing stress and retirement as the main reasons.
Nearly one in four (37%) GPs responding to the survey said there were GP vacancies in the practice where they work, while 5% said their practice will probably close in the next year.
The findings are in keeping with the latest national GP worklife survey, which found that a record number of GPs are planning to quit in the next five years, mostly due to ‘high or considerable pressure’ from increasing workload.
The RCGP warned that NHS England faces an ‘uphill battle’ to sustain general practice for the future - despite record numbers of GP trainees being recruited this year. It called for retention of the existing GP workforce to be given equal priority to recruitment of new GPs.
GP workforce
Although the latest GP workforce data from NHS Digital show that full-time equivalent GP numbers remained stable over the past year, the total number of GPs working in England remains 460 below the level it was at in September 2015 - when the government pledged an extra 5,000 GPs.
Data also shows that there were 320 GPs retained via the GP retention scheme at the end of September this year - up from 218 in September 2017. However, analysis shows that the uptake of the scheme is being dwarfed by the numbers quitting general practice each month.
RCGP chair Professor Helen Stokes-Lampard said: ‘NHS England and Health Education England (HEE) have done excellent work, supported by the RCGP and others, to encourage more doctors to specialise in general practice and we now have more GPs in training than ever before. But GP specialty-training takes three years, and if as many GPs are leaving the profession as entering it, we are fighting an uphill battle, when realistically we need thousands more.
‘We need to see this level of effort replicated in initiatives to retain GPs already in the profession, to reduce our escalating and often unnecessary workload, and to support GPs and our teams' own health and wellbeing.’
GP wellbeing
The RCGP’s findings come at a time of rising concern over GP wellbeing. In September, almost 1,200 GPs were receiving help from the GP Health Service, and a poll from RCGP Scotland published earlier this year showed that one in five GPs were ‘too stressed to cope’.
Just last week, findings from the GMC’s Training Environments 2018 report showed that 90% of GP trainers work beyond their normal hours on a weekly basis with over half describing the work as ‘emotionally exhausting’.
‘All GPs are overworked, many are stressed, and some are making themselves seriously ill working hours that are simply unsafe, for both themselves and their patients - it is making them want to leave the profession. It is forcing some GPs to hand back their keys and close their surgeries for good,’ said Professor Stokes-Lampard.
‘About a third of the GPs we surveyed said they were unlikely to be working in general practice in five years' time. This is gravely concerning. We are talking about highly-trained, highly-skilled doctors, that the NHS is at risk of losing – some will retire, which is to be expected, but many are planning to leave earlier than they otherwise would have done because of stress and the intense pressures they face on a day to day basis, whilst simply trying to do their best for their patients.’
Investment
GPC chair Dr Richard Vautrey said that although the RCGP’s findings are ‘alarming’, they are not surprising.
He said: ‘While GPs strive to provide high quality care to all of their patients, statistics such as this speak volumes to the huge amount of pressure they are under; rising demand from a growing population with increasingly complex conditions means that workload is nearing insurmountable levels.
‘Given the stress this causes and impact that it has on doctors’ wellbeing, it is unsurprising that many are questioning their own futures and the future of their practices.’
He added: ‘For the last 70 years general practice has been the foundation on which the NHS is built, but without proper support, investment and a plan to tackle the current retention crisis, it is in serious risks of crumbling.’
Both the RCGP and the BMA are calling on the government to use its long-term plan to increase the share of the NHS budget that general practice receives to a minimum of 11%.
A DHSC spokesperson said: ‘GPs are the bedrock of the NHS and last week the prime minister set out a major new investment in primary and community healthcare – worth an extra £3.5bn a year in real terms by 2023/4. This year a record 3,473 doctors were recruited into GP training and we are determined to recruit an extra 5,000 doctors into general practice.’
