Key points

  • The Commonwealth Fund surveyed 13,200 primary care physicians across 11 countries between January and June 2019. This included 1,001 general practitioners (GPs) from the UK. The Health Foundation analysed the data and reports on the findings from a UK perspective.
  • In some aspects of care, the UK performs strongly and is an international leader. Almost all UK GPs surveyed use electronic medical records, and use of data to review and improve care is relatively high.
  • The survey also highlights areas of major concern for the NHS. Just 6% of UK GPs report feeling ‘extremely’ or ‘very satisfied’ with their workload – the lowest of any country surveyed. Only France has lower overall GP satisfaction with practising medicine. GPs in the UK also report high stress levels, and feel that the quality of care that they and the wider NHS can provide is declining.
  • A high proportion of surveyed UK GPs plan to quit or reduce their working hours in the near future. 49% of UK GP respondents plan to reduce their weekly clinical hours in the next 3 years (compared to 10% who plan to increase them).
  • UK GPs continue to report shorter appointment lengths than the majority of their international colleagues. Just 5% of UK GPs surveyed feel ‘extremely’ or ‘very satisfied’ with the amount of time they can spend with their patients, significantly lower than the satisfaction reported by GPs in the other 10 countries surveyed.
  • Workload pressures are growing across general practice, and UK GPs report that they are doing more of all types of patient consultations (including face-to-face, telephone triage and telephone consulting). Policymakers expect GPs to be offering video and email consultations to patients who want them in the near future, but the survey suggests that this is currently a long way from happening. Only 11% of UK GPs report that their surgeries provide care through video consultation.

This publication presents UK-focused analysis of The Commonwealth Fund’s 2019 International Health Policy Survey of Primary Care Doctors in 11 Countries. This includes responses to several UK-specific questions funded by the Health Foundation.

The 2019 Commonwealth Fund survey compares perspectives from GPs across 11 high‑income countries. The survey asked GPs’ views on their working lives, changes in how they deliver services, and the quality of care they can provide to patients.

The previous Commonwealth Fund survey in 2015 showed that UK GPs were the most stressed of the 11 countries surveyed, with more than one in five GPs reporting being made ill by the stress of work in the previous 12 months. But since 2015, pressure on general practice in the UK has increased. The population has grown and the number of GPs (headcount) per person has fallen. Higher GP workload has negatively impacted on GP morale, increasing the likelihood of GPs leaving the profession or reducing hours, and worsening workforce shortages.

Against this backdrop, we present our analysis of the data – including comparisons with the 2015 survey where possible. The data are presented under three main themes:

1. how GPs view their job

2. what care GPs are providing and how it is changing

3. how GPs work with other professionals and services.

The results are presented for the UK as a whole, with differences between UK countries highlighted only when they are of particular interest. The final section of this analysis discusses the implications of the results and what they mean for policy in England, though the implications we identify are likely to be broadly relevant across the UK.

Cite this publication

Fisher R, Turton C, Gershlick B, Alderwick H, Thorlby R: Feeling the strain. Health Foundation; 2020 (https://www.health.org.uk/publications/reports/feeling-the-strain)

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