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a stethoscope image cbFebruary 6 2018

A range of issues have been identified as influencing GPs’ thoughts about whether to stay in practice having direct patient care.


The University of Exeter study interviewed GPs about their concerns but also asked about what might make them stay in practice, or return to practice in some cases. The study followed on from a recent survey of all GPs in South West England. This had revealed that 37% of GPs reported a high likelihood of quitting direct patient care within five years. In addition, 70% of GPs had reported a career intention that, if implemented, would negatively impact GP workforce capacity and availability.

This latest study involved in depth interviews with 41 GPs as well as 19 other stakeholders. Three core themes were identified in GPs’ thoughts about staying in practice:

  • a sense that general practice based primary care was under-valued within the healthcare system;
  • concerns regarding professional risk encountered in delivering care in an increasingly complex health environment;
  • considerations about leaving or remaining in direct patient care and the options and choices that GPs felt were available to them.

Professor John Campbell, who led the study and is a practising GP, said: “Our new research is a significant study of what is driving the exodus of GPs from direct patient care. Policy makers need to take this onboard and address these issues to retain GPs and encourage medical students to take up a career in general practice.

“Despite recent government plans to address the problem, numbers are continuing to fall. If we do not act now, many areas will face a severe shortfall in the number of GPs providing care for patients their area … we now need sustained, strategic, and stable planning of health services – not a series of short-term ‘fixes’ which only destabilise clinical care further. Innovation is essential, but needs to be based on firm evidence.”

Professor Helen Stokes-Lampard, RCGP Chair, said the research “hammers home why the College’s calls for thousands more GPs must be heard and acted upon.

“GP workload has increased by at least 16% over the last seven years – and become far more complex – but the share of the overall NHS budget that general practice receives is less that it was a decade ago, and our workforce has not risen at pace.”

Calling for NHs England’s pledge of 5,000 more GPs to be in place by 2020, Prof Stokes-Lampard warned that there was a risk of numbers falling short. “The latest workforce figures actually showed a concerning drop of more than 600 full-time equivalent family doctors between March-September last year,” she said.

“Ultimately, it’s our patients who suffer when we lose GPs, and this study not only highlights the need to recruit more doctors into general practice for the future, but to also take measures to retain existing and experienced doctors working in NHS general practice.”

Links:
University of Exeter announcement      
A Sansom et al. ‘Why do GPs leave direct patient care and what might help to retain them? A qualitative study of GPs in South West England’. BMJ Open 2018; 8: e019849.        
RCGP comment            

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