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| NHS has the west's most stressed GPs, survey reveals | NHS has the west's most stressed GPs, survey reveals |
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| The NHS has the most stressed GPs by western standards, as a result of relentless workloads, endless bureaucracy and the shortest amount of time spent with patients, new research by the world’s most influential health thinktank reveals. | The NHS has the most stressed GPs by western standards, as a result of relentless workloads, endless bureaucracy and the shortest amount of time spent with patients, new research by the world’s most influential health thinktank reveals. |
| Related: I ring her a few hours later and the headache has gone. We both breathe a sigh of relief. | Related: I ring her a few hours later and the headache has gone. We both breathe a sigh of relief. |
| Stress levels are so acute among British GPs that almost 30% plan to quit in the next five years, in a move that would make it even harder for patients to get an appointment promptly. The growing pressures on NHS family doctors are so intense that more than 20% have become ill in the past year, according to the findings from the authoritative Washington-based Commonwealth Fund. | Stress levels are so acute among British GPs that almost 30% plan to quit in the next five years, in a move that would make it even harder for patients to get an appointment promptly. The growing pressures on NHS family doctors are so intense that more than 20% have become ill in the past year, according to the findings from the authoritative Washington-based Commonwealth Fund. |
| Just under six in 10 GPs (59%) find their work stressful, with 39% of these saying it is very stressful| and 20% extremely stressful, which is higher than any other leading western nation in the triannual study. Researchers surveyed 11,547 GPs in 11 countries, including France, Germany and the United States. | Just under six in 10 GPs (59%) find their work stressful, with 39% of these saying it is very stressful| and 20% extremely stressful, which is higher than any other leading western nation in the triannual study. Researchers surveyed 11,547 GPs in 11 countries, including France, Germany and the United States. |
| “These worrying findings reveal the scale of the challenge facing general practice,” said Dr Jennifer Dixon, chief executive of the UK-based Health Foundation thinktank, which helped with the study. | “These worrying findings reveal the scale of the challenge facing general practice,” said Dr Jennifer Dixon, chief executive of the UK-based Health Foundation thinktank, which helped with the study. |
| Jeremy Hunt, the health secretary, declined to comment on the findings or whether they affected his pledge last year to recruit 5,000 extra GPs. But he responded on Tuesday to mounting criticism that GP services in England are underfunded, given their growing workload, by outlining plans that will give them a 4%-5% a year increase in their budget every year until 2020-21. That should boost their budget from £7.3bn to £9.2bn a rise of £1.9bn. | |
| “General practice is the jewel in the crown of the NHS and central to the future of the health service,” Hunt said, adding that he was determined to ease growing pressures on the profession. | |
| Researchers at the Commonwealth Fund found that family doctors in Britain spend less time with their patients than anywhere else. In all, 92% of the 1,001 GPs surveyed said they spent less than 15 minutes talking to patients, while internationally in the survey just 27% of GPs spent less than this time. Similarly, only 8% of NHS GPs are spending more than 15 minutes with patients; on average, almost three-quarters (73%) of patients get at least that long. | |
| These short consultations are GPs’ single biggest source of stress and discontent, the study found. What one expert called the “relentless appointment treadmill” of brief consultations is fuelling family doctors’ deep dissatisfaction with their jobs. Just 26% of GPs feel they have enough time with patients while the international average is more than double that at 59%. | These short consultations are GPs’ single biggest source of stress and discontent, the study found. What one expert called the “relentless appointment treadmill” of brief consultations is fuelling family doctors’ deep dissatisfaction with their jobs. Just 26% of GPs feel they have enough time with patients while the international average is more than double that at 59%. |
| Many surgeries operate a 10-minute rule, which can leave both doctors and patients feeling frustrated that they have not had enough time to discuss medical concerns properly. GPs fear that such short face-to-face meetings mean they could miss vital symptoms, misdiagnose an illness or not have enough time to investigate an ailment properly. | Many surgeries operate a 10-minute rule, which can leave both doctors and patients feeling frustrated that they have not had enough time to discuss medical concerns properly. GPs fear that such short face-to-face meetings mean they could miss vital symptoms, misdiagnose an illness or not have enough time to investigate an ailment properly. |
| The findings have raised fresh doubts about the government’s pledge to tackle the already chronic shortage of GPs in many parts of England by boosting the workforce by 5,000 by 2020. | The findings have raised fresh doubts about the government’s pledge to tackle the already chronic shortage of GPs in many parts of England by boosting the workforce by 5,000 by 2020. |
| Dixon said: “There is already a shortage of GPs in the NHS and with 29% reporting that they are planning to leave within five years, we must urgently understand the reasons for UK GPs’ dissatisfaction.” | Dixon said: “There is already a shortage of GPs in the NHS and with 29% reporting that they are planning to leave within five years, we must urgently understand the reasons for UK GPs’ dissatisfaction.” |
| In all, 29% of doctors plan to leave general practice within five years, with 4% switching to another career altogether, 8% moving to another branch of medicine and 17% retiring. But the exit rate could prove even higher as only 53% said they would definitely continue in general practice, with another 17% unsure of their plans. | In all, 29% of doctors plan to leave general practice within five years, with 4% switching to another career altogether, 8% moving to another branch of medicine and 17% retiring. But the exit rate could prove even higher as only 53% said they would definitely continue in general practice, with another 17% unsure of their plans. |
| Dixon said: “The survey suggests that UK GPs’ unhappiness may be driven by their spending less time with patients than they would like. The relentless appointment treadmill experienced by UK GPs is in stark contrast to that reported by their peers overseas.” | Dixon said: “The survey suggests that UK GPs’ unhappiness may be driven by their spending less time with patients than they would like. The relentless appointment treadmill experienced by UK GPs is in stark contrast to that reported by their peers overseas.” |
| Prof Nigel Mathers, the honorary secretary of the Royal College of GPs, warned that overworked GPs increased the chances of them making a mistake. “Such high levels of stress amongst GPs in the UK compared to other countries is bad news for the NHS and for our patients, as growing numbers of family doctors are becoming dissatisfied with their working circumstances and consider leaving the profession.” | Prof Nigel Mathers, the honorary secretary of the Royal College of GPs, warned that overworked GPs increased the chances of them making a mistake. “Such high levels of stress amongst GPs in the UK compared to other countries is bad news for the NHS and for our patients, as growing numbers of family doctors are becoming dissatisfied with their working circumstances and consider leaving the profession.” |
| Stress is the key reason so many GPs intend to quit. The Health Foundation’s forthcoming analysis of the American thinktank’s findings about NHS GPs reports that: “There is a clear correlation between those who want to leave general practice and stress levels. In the UK, 29% of GPs plan to leave general practice within five years. Of those planning to leave medicine for a different career, 82% identified their role as extremely stressful. In contrast, of those who plan to stay, 48% identify it as extremely or very stressful.” | Stress is the key reason so many GPs intend to quit. The Health Foundation’s forthcoming analysis of the American thinktank’s findings about NHS GPs reports that: “There is a clear correlation between those who want to leave general practice and stress levels. In the UK, 29% of GPs plan to leave general practice within five years. Of those planning to leave medicine for a different career, 82% identified their role as extremely stressful. In contrast, of those who plan to stay, 48% identify it as extremely or very stressful.” |
| Ministers and the NHS should prioritise efforts to relieve the growing pressures on GPs as well as a drive to significantly expand the workforce, the Health Foundation says. “These findings show that holding on to existing GPs by improving their working lives should be as great a priority as recruiting new GPs,” its analysis adds. GP leaders and NHS policy analysts believe it is highly unlikely that Jeremy Hunt, the health secretary, will meet his target of 5,000 more GPs by 2020. | |
| Mathers said: “This relentless demand, without increasing resources or workforce to deal with it, is a threat to our own health and our patients’ safety as tired – and stressed – doctors are more likely to make mistakes. | Mathers said: “This relentless demand, without increasing resources or workforce to deal with it, is a threat to our own health and our patients’ safety as tired – and stressed – doctors are more likely to make mistakes. |
| “The fact that GP appointments in the UK are the shortest of those countries included in this survey is also concerning. We want to spend longer with our patients, particularly those with multiple and chronic conditions, for which the standard 10-minute consultation is increasingly inadequate – we simply don’t have the capacity to do this as a matter of course.” | “The fact that GP appointments in the UK are the shortest of those countries included in this survey is also concerning. We want to spend longer with our patients, particularly those with multiple and chronic conditions, for which the standard 10-minute consultation is increasingly inadequate – we simply don’t have the capacity to do this as a matter of course.” |
| But the results were not surprising, Mathers added. “GPs and our teams across the country are working harder than ever, doing more consultations than ever, to meet the increasing demand of our growing and ageing population. This year we will do in excess of 370m patient consultations – 60m more than we did five years ago.” | But the results were not surprising, Mathers added. “GPs and our teams across the country are working harder than ever, doing more consultations than ever, to meet the increasing demand of our growing and ageing population. This year we will do in excess of 370m patient consultations – 60m more than we did five years ago.” |
| Dixon said: “Focusing on recruiting new GPs alone will not solve the shortage if there’s a leaky bucket. It is critical that the government understands the pressures on GPs and acts on the retention challenges highlighted by this survey.” | Dixon said: “Focusing on recruiting new GPs alone will not solve the shortage if there’s a leaky bucket. It is critical that the government understands the pressures on GPs and acts on the retention challenges highlighted by this survey.” |
| The study surveyed 675 GPs in England, 136 from Scotland, 110 from Wales and 80 from Northern Ireland. It also found that while British GPs generally feel well-paid, they are also some of the most dissatisfied internationally. While 67% are satisfied with practising medicine, that is 12% lower than the average across the other 10 countries surveyed of 79%. UK GPs came eighth out of 11 countries on that score, behind the US (65%), France (64%) and Germany (63%). | The study surveyed 675 GPs in England, 136 from Scotland, 110 from Wales and 80 from Northern Ireland. It also found that while British GPs generally feel well-paid, they are also some of the most dissatisfied internationally. While 67% are satisfied with practising medicine, that is 12% lower than the average across the other 10 countries surveyed of 79%. UK GPs came eighth out of 11 countries on that score, behind the US (65%), France (64%) and Germany (63%). |
| GP satisfaction levels have suffered a sharp drop – down by 14% from 81% – since they were asked the same question in 2009. The intervening years have seen GP workloads rise as a result of the ageing population, having to manage more people with several long-term conditions such as diabetes or heart failure and the shifting of responsibility from hospitals on to family doctors. | GP satisfaction levels have suffered a sharp drop – down by 14% from 81% – since they were asked the same question in 2009. The intervening years have seen GP workloads rise as a result of the ageing population, having to manage more people with several long-term conditions such as diabetes or heart failure and the shifting of responsibility from hospitals on to family doctors. |
| Hunt is currently finalising the details of a new package of measures to boost GP recruitment and retention which will be unveiled next month. He said: “I am determined that we will address growing pressures on GPs and do even more to support the profession. So, in February, we’ll be announcing a new package of measures working with the RCGP and the British Medical Association. | |
| “We’ll continue to reduce the burden of bureaucracy in general practice, and the Care Quality Commission will be looking at what more they can do to streamline their inspections. | |
| “On top of this, I want to increase the proportion of funding going into general practice, so with NHS England we are now promising to invest 4%-5% more per year in general practice for the rest of this parliament on top of the extra funding clinical commissioning groups will put into primary care.” | |
| NHS England has allocated the extra money for GPs from within its budget, and approved the plan last month. |