Just 1 in 4 UK GPs are satisfied with time they are able to spend with patients – appointment times are among the shortest of 11 countries surveyed
A report published today by independent charity the Health Foundation paints a picture of high stress and low satisfaction with workload among UK GPs. The report is an analysis of an international survey of GPs from 11 high-income countries, including 1,001 UK GPs, undertaken by the Commonwealth Fund in 2019.
Among 11 high-income countries included in the study, only France has lower levels of overall satisfaction with practising medicine, and only Sweden reported higher levels of stress. Over half of UK GPs (60%) say they find their job 'extremely' or 'very' stressful, and almost half (49%) plan to reduce their weekly hours in the next three years.
UK GPs also reported significantly shorter appointment lengths than their international colleagues. The average length of a GP appointment in the UK is 11 minutes, compared with a 19 minute average appointment for GP and primary care physicians in the other countries surveyed. UK GPs are the least satisfied with the amount of time they are able to spend with patients – just 1 in 4 UK GPs (29%) feel satisfied with the length of time spent with patients, and just 5% feel 'extremely' or 'very' satisfied.
Workload pressures are growing across general practice. Despite a 2015 target for 5,000 additional GPs by 2020, the number of qualified permanent full time equivalent GPs in the UK has fallen. There are now 1,700 fewer qualified permanent GPs than in 2015. The number of patients per GP has grown, from 2,180 to 2,240 last year alone, placing greater workload on practitioners. In the survey, UK GPs also report that they are doing more of most types of patient consultation, including face to face, telephone triage and telephone consulting.
Primary Care Networks were introduced in 2019 as a response to problems facing general practice in England and to deliver the ambitions within the NHS Long Term Plan. These findings offer a stark reminder of the size of the task required to stabilise general practice, let alone to reform primary care.
In some aspects of care, the UK performs strongly and is an international leader. Almost all (99%) UK GPs surveyed use electronic medical records, and use of data to review and improve patient care is relatively high, in comparison to international counterparts. GPs in the UK are also broadly supportive of ambitions to improve integration of services – a key aim for policymakers.
In other respects GPs report that the system is not yet getting the basics right. In particular, communication with hospitals is often too slow – only 8% of UK GPs report that they 'usually receive a report within a week of a specialist review'. GPs are not optimistic about the trajectory of NHS performance: 18% think performance has improved in the past three years, while 46% feel it has declined.
Dr Rebecca Fisher, one of the Health Foundation report's authors and a practising GP, says:
'These findings illustrate the pressures faced by general practice, and the strain that GPs are under. Right now the health system is in unprecedented territory and mobilising to meet the challenge of COVID-19. This survey shows that over the long term we need concerted action to stabilise general practice.
'Despite performing strongly in some aspects of care, many GPs consider that appointments are simply too short to fully meet the needs of patients. Too many GPs are highly stressed and overburdened – to the point of wanting to leave the profession altogether.
'Policymakers need to be sure not to build castles on quicksand. Primary Care Networks are intended to reform general practice, but solutions that rely on the existing GP workforce doing more are likely to misfire. Bringing in additional workforce, from pharmacists to physios, is welcome but will not quickly solve the immediate pressures facing GPs.'
The report highlights a number of recommendations for policymakers in England:
- Do more to understand what would keep GPs in practice, with solutions rapidly implemented. The measures that have been tried so far are not turning the tide on GPs' intentions to reduce their hours or leave practice altogether.
- Enable GPs to offer longer appointment times. This is particularly difficult in the face of rising patient need and falling GP numbers; however, GPs with longer appointment times report greater job satisfaction.
- Improve the speed of communication with hospitals. Although the UK performs reasonably well in terms of sharing clinical information between practices and hospitals, GPs report that these processes are often too slow.
- Put in place realistic ambitions for digitally enabled primary care. The survey findings show that most GPs in the UK are a long way from meeting ambitious targets set by government to offer digital services to patients.
Notes to editors
The Commonwealth Fund surveyed 13,200 primary care physicians across 11 countries between January and June 2019, as part of Feeling the Strain: What the Commonwealth Fund’s 2019 international survey of general practitioners means for the UK. This included 1,001 general practitioners (GPs) from the UK. The Health Foundation analysed the data and is reporting on the findings from a UK perspective.
The Commonwealth Fund’s 2019 International Health Policy is a survey of primary care doctors in 11 countries.