Annual GMC audit warns of unmanageable GP workloads

The Government and NHS must take ‘urgent action’ to break the ‘vicious cycle’ of unmanageable workloads, dissatisfaction and burnout that is causing GPs to quit, the GMC has warned.

In its State of Medical Education and Practice 2023 report, the GMC found dramatic increases in the number of doctors who said they felt unable to cope with their workload and found it difficult to provide patient care at least once a week, with GPs faring particularly badly.

Overall, just half of 4,000 doctors surveyed said they were satisfied in their work, down from 70% in 2021.

But in 2022, only 38% of GPs said they were satisfied, fewer than other doctors and down from 51% the previous year, the GMC found.

More than half of GPs (55%) were struggling with their workload, compared with 38% of all doctors and 62% of GPs found it difficult to provide sufficient patient care each week.

GPs also reported more high-intensity days (78%) than other doctors and fewer low intensity days (3%), the analysis showed.

The regulator warned doctors were changing their working patterns, places of work and re-thinking their careers because they increasingly feel unable to cope.

This was creating a ‘vicious cycle’ that was putting patient safety at risk, the report said.

More doctors than ever said they were likely to leave the UK workforce and had taken ‘hard steps’ towards doing so, they added.

Recommendations by the report for things that can be done now and would make a difference include:

• Ensuring doctors feel valued by their employers
• Developing better and more consistent induction and onboarding
• Developing flexible rota design
• Providing workplace rest and refreshment facilities

And in the longer-term priorities should include:

• Making work intensity more sustainable with a clear need to increase overall capacity
• Increasing training capacity with doctors supported and given protected time to train others
• Building trainees’ confidence and autonomy with time set aside to develop competences and confidence rather than constantly having to plug gaps in a struggling workforce
• Strengthening support for primary care by addressing pressures in general practice to protect patient safety and staff wellbeing and considering how more trainee doctors can be encouraged to choose primary care as a specialism.

GMC chief executive Charlie Massey said: ‘More clinicians than ever are telling us they are taking steps to leave the profession, and the gap they could leave behind will only compound workload pressures and feed into a vicious cycle.

‘It’s especially worrying to see the impact on trainers, who are critical for ensuring that our doctors in training develop the skills and confidence they need.

‘Any government commitments to expand medical training places, whilst welcome, will flounder if the needs of the trainer workforce are not urgently met.’ 

RCGP chair Professor Kamila Hawthorne, said the GMC findings were a stark reminder of the workforce crisis facing general practice and the wider NHS, ‘but sadly, they come as no surprise’.

‘For years, the College has warned that without urgent action on recruitment and retention, the number of GPs retiring earlier than planned or leaving the profession altogether would continue to rise – often due to their own burnout, rock-bottom morale, and a great sense of moral distress at the number of patients struggling to access care.’

She added that a dwindling number of GPs are facing an almost impossible workload, that continuously grows in both volume and complexity.

‘We are delivering millions more appointments compared to before the pandemic, with almost half on the same day of booking. But we are doing so with 930 fewer fully qualified full-time-equivalent GPs compared to 2019. It is little wonder that our own College survey suggests a further 22,000 GPs could leave in the next five years.’

Dr Sabira Hughes, medicolegal consultant at the Medical Protection Society, said many doctors were exhausted and burnt out.

‘Our own research shows that two in five doctors feel their mental wellbeing is currently impacted by not being able to do the right thing for patients.

‘Doctors must have access to specialist mental wellbeing support.

‘Without this more doctors will become disillusioned or suffer in silence with mental wellbeing issues – both of which put the safety of themselves and potentially their patients at risk.’