GPs in the UK experience the highest levels of stress and have the lowest job satisfaction compared with doctors in other high-income countries, new analysis has found.
A Health Foundation report published today analysed data from a survey of 9,526 GPs in 10 countries, including 1,010 in the UK, carried out by the Commonwealth Fund.
The report found that UK GPs reported ‘higher levels of emotional distress’ and ‘bigger rises in workload’ than GPs in nearly all other countries, with many considering leaving the profession altogether.
The Health Foundation said that 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 foundation said.
The report said: ‘The experience of GPs in the UK should ring alarm bells for government. 71% say their job is “extremely” or “very stressful” – the highest of the 10 countries surveyed alongside Germany.
‘UK GPs are also among the least satisfied with practising medicine, work-life balance, workload, time spent with patients and other parts of their jobs.’
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.’
He added: ‘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.’
He called for ‘decisive policy action’ to improve the working lives of GPs, including boosting GP capacity, reducing workload and making use of other 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,’ he said.
RCGP chair Professor Kamila Hawthorne said the college has long warned that without urgent action, general practice in the UK ‘will become unsustainable’.
She said: ‘It is alarming, but not at all surprising, that GPs in the UK are amongst the most stressed and over-stretched of the nations examined.
‘GPs and our teams want to deliver safe, appropriate and timely care for our patients, but with the intense workload and workforce pressures we are working under, this is becoming ever more difficult.
‘GP teams have emerged from the pandemic exhausted, making more patient consultations than before it – an increase of 9% on 2019 – but with 843 fewer fully-qualified, full time equivalent GPs.’
She added that the forthcoming primary care recovery plan and NHS workforce plan would be ‘key opportunities’ to address the workload and workforce pressures.
Meanwhile, Dr Kieran Sharrock, acting chair of GPC England at the BMA, said that the findings were ‘unfortunately unsurprising.’
He said: ‘Workload in general practice has become totally unsustainable and GPs are burning themselves out trying to keep up with rising patient demand. It really worries me that so many of my colleagues are reporting that they are stressed and burnt out.
‘Many talented and experienced doctors are becoming disenchanted and feel as though they have no choice but to reduce their hours or leave the profession altogether, ultimately depriving communities of the care they need. We’ve now lost the equivalent of 2,078 fully qualified full-time GPs since September 2015.’
He agreed that the Government must act to tackle the crisis and reduce ‘harmful workloads’, or pressures will ‘only get worse’.
If this continues, ‘we will reach a point where there won’t be a general practice left to save,’ he warned.
Strengths of general practice
The survey also looked at 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.
In particular, GPs in the UK 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.
Professor Hawthorne added: ‘It’s not all bad news. The UK is further ahead than most other countries on some elements like practices offering online repeat prescriptions, and more GPs feel their practice is prepared with the right skills and experience to manage patients with dementia, chronic illnesses and for palliative care.
‘It’s also clear from the report that the fundamentals of general practice in the UK are good and worth supporting.
‘GPs and our teams make the vast majority of patient contact in the NHS, and by doing so we alleviate pressures across the health service, including in A&E.
‘But it does show, without a doubt, that as the foundation of the NHS, we are struggling.’
Key findings in the report
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.
A version of this story was first published on our sister title Pulse.