General practitioner wellbeing during the COVID-19 pandemic: a qualitative interview study

Abstract

Background Workload pressures and poor job satisfaction have been reported by UK general practitioners (GPs) for some time. The COVID-19 pandemic presented new challenges, with growing international evidence of its negative impact on GP mental health and wellbeing. While there has been wide commentary on this topic, UK research evidence is lacking. Developing greater understanding of these lived experiences and subgroup differences is important as doctor wellbeing may affect the sustainability of health care systems and quality of patient care. Objectives To explore the lived experience of UK GPs during COVID-19, and the pandemic impact on their psychological wellbeing. Design and Setting In-depth qualitative interviews, conducted remotely by telephone or video call, with NHS GPs. Participants GPs were sampled purposively across three career stages (early career, established and late career or retired GPs) with variation in other key demographics. A comprehensive recruitment strategy used multiple channels. Data were analysed thematically using Framework Analysis. Results We interviewed 40 GPs; most described generally negative sentiment and many displayed signs of psychological distress and burnout. Causes of stress and anxiety related to personal risk, workload, practice changes, public perceptions and leadership, teamworking and wider collaboration and personal challenges. GPs described facilitators of their wellbeing, including sources of support and plans to reduce clinical hours or change career path. Conclusions A range of factors detrimentally affected the wellbeing of GPs during the pandemic and we highlight the potential impact of this on workforce retention and quality of care. As the pandemic progresses and general practice faces continued challenges, urgent policy measures are now needed.

UK newspapers ‘on the warpath’: media analysis of general practice remote consulting in 2021

“…There is emerging evidence that it also contributes to workforce stress and the retention crisis. A qualitative study of 40 UK GPs conducted in 2020–2021, 25 and a social media analysis of GPs’ postings during the pandemic by the same authors, 26 both found that negative media portrayals of general practice (especially the implication that practices were closed when the reality consisted of long hours and high workload) were a significant factor contributing to low morale. The current authors’ own ongoing empirical research has begun to identify similar findings among GPs and their support staff.…”

GP workforce crisis: what can we do now?

“…We use Michael West's framework -the ABC of needs 6,7 -to frame policy solutions for general practice using the concepts of autonomy, belonging, and contribution that have previously been shown to be integral to promoting the wellbeing of the health workforce. Our own research evidence 4,8,9 highlights how these key characteristics were eroded during the COVID-19 pandemic, but understanding the importance of these facets may also offer future solutions.…”

“…BELONGING Doctors need to feel valued, respected, and supported in their work; 6,7 yet experiences during the pandemic highlight real issues of fear and blame in general practice. 8,9 GPs' sense of belonging has been threatened further by remote working and increased pressures on teams. 8 Supportive, compassionate leadership is needed at all levels.…”

“…8,9 GPs' sense of belonging has been threatened further by remote working and increased pressures on teams. 8 Supportive, compassionate leadership is needed at all levels. From the national to the regional and local practice levels, there are steps that could be taken to increase this sense of belonging.…”

The well‐being of nurses working in general practice during the COVID‐19 pandemic: A qualitative study (The GenCo Study)

“…This includes delivering the bulk of long‐term condition management, public health interventions such as immunization and vaccination programmes (Public Health England, 2020), essential care which cannot be delayed and procedures requiring face‐to‐face consultations, for example, complex dressings, cervical cytology (Clifford et al., 2021; Russell et al., 2022). While General Practitioners' experiences of the COVID‐19 pandemic have been variously explored, (Gray et al., 2020; Jefferson, Heathcote, & Bloor, 2022; Khan et al., 2020; Royal College of General Practitioners, 2020; Verhoeven et al., 2020), and potential implications for future practice considered, there has been much less consideration of the experiences of nurses working in general practice and how this has impacted on the professional well‐being of nurses.…”