GPs: working harder than ever

Paddison, Charlotte; Abel, Gary; Campbell, John

doi:10.3399/bjgp18x695873

Cited by 8 publications

(8 citation statements)

References 6 publications

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“…GPs mainly respond to common diseases and general emergencies [ 3 ]. GPs often efficiently provide care, quickly treat ailments, and somewhat justify referrals and hospitalizations for difficult cases [ 4 ]. In 2019, there were 44,570 fulltime GPs in the United Kingdom, which was an increase of 2.7% since 2018 [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The global prevalence of turnover intention among general practitioners: a systematic review and meta-analysis

Shen

Jiang

et al. 2020

BMC Fam Pract

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Background General practitioners (GPs) are the foundation of any primary healthcare system. Their quality and quantity are directly associated with the effectiveness and quality of the health services of a nation. GPs’ shortage and turnover have become an important issue in developed and developing countries. An accurate estimate of turnover intention prevalence among GPs would have important health policy implications, but the overall prevalence is unknown. We aimed to summarize the global prevalence of turnover intention and associated factors among GPs. Methods We systematically reviewed the PubMed, Embase, Web of Science and China National Knowledge Infrastructure (CNKI) databases from their inception up to May 2020, as well as the reference lists of all included studies. We included observational studies that reported data on turnover intention or their prevalence rate among GPs could be calculated based on the information provided. The prevalence rate of the turnover intentions was estimated using a random-effects meta-analysis. The heterogeneity was evaluated using I2 statistic. Differences by study level characteristics were estimated via subgroup analysis and meta-regression. Results A total of 25 cross-sectional studies were included (a total of 27,285 participants). The prevalence of turnover intention was 0.47 (95% CI: 0.39–0.55). Those having a lower level of salary (OR = 1.38, 95% CI: 1.13–1.63) and job satisfaction (OR = 1.35, 95% CI: 1.12–1.70) or having lower level of morale (OR = 2.68, 95% CI: 1.56–3.80) had a higher intention. In contrast, GPs with a lower level of professional title had a lower turnover intention (OR = 0.81, 95% CI: 0.65–0.98). Conclusions In this systematic review, approximately half of the GPs had the intention to leave their current posts worldwide. The factors associated with turnover intention were higher professional title, lower income level, lower job satisfaction and lower morale.

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Section: Introductionmentioning

confidence: 99%

The global prevalence of turnover intention among general practitioners: a systematic review and meta-analysis

Shen

Jiang

et al. 2020

BMC Fam Pract

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“…There is, however, a need for the rational deployment of the GP workforce resource 10 11. Various models exist to inform that deployment, with GP workload representing a key issue among individual GPs electing to quit patient care 3.…”

Section: Introductionmentioning

confidence: 99%

Workforce predictive risk modelling: development of a model to identify general practices at risk of a supply−demand imbalance

et al. 2020

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ObjectiveThis study aimed to develop a risk prediction model identifying general practices at risk of workforce supply–demand imbalance.DesignThis is a secondary analysis of routine data on general practice workforce, patient experience and registered populations (2012 to 2016), combined with a census of general practitioners’ (GPs’) career intentions (2016).Setting/ParticipantsA hybrid approach was used to develop a model to predict workforce supply–demand imbalance based on practice factors using historical data (2012–2016) on all general practices in England (with over 1000 registered patients n=6398). The model was applied to current data (2016) to explore future risk for practices in South West England (n=368).Primary outcome measureThe primary outcome was a practice being in a state of workforce supply–demand imbalance operationally defined as being in the lowest third nationally of access scores according to the General Practice Patient Survey and the highest third nationally according to list size per full-time equivalent GP (weighted to the demographic distribution of registered patients and adjusted for deprivation).ResultsBased on historical data, the predictive model had fair to good discriminatory ability to predict which practices faced supply–demand imbalance (area under receiver operating characteristic curve=0.755). Predictions using current data suggested that, on average, practices at highest risk of future supply–demand imbalance are currently characterised by having larger patient lists, employing more nurses, serving more deprived and younger populations, and having considerably worse patient experience ratings when compared with other practices. Incorporating findings from a survey of GP’s career intentions made little difference to predictions of future supply–demand risk status when compared with expected future workforce projections based only on routinely available data on GPs’ gender and age.ConclusionsIt is possible to make reasonable predictions of an individual general practice’s future risk of undersupply of GP workforce with respect to its patient population. However, the predictions are inherently limited by the data available.

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“…In the UK, it has become increasingly difficult for primary care providers to recruit sufficient GPs to keep pace with the growing demands of rising workloads 1 , 2. In the context of a global shortfall of trained family doctors,3 , 4 initiatives to improve recruitment have not been effective 5.…”

Section: Introductionmentioning

confidence: 99%

“…In the context of a global shortfall of trained family doctors,3 , 4 initiatives to improve recruitment have not been effective 5. Instead, workload pressures and low morale have been accompanied by an increase in early retirement rates and increased concerns about the sustainability of current models of primary care 2 , 6 – 9…”

Section: Introductionmentioning

confidence: 99%

The influence of training experiences on career intentions of the future GP workforce: a qualitative study of new GPs in England

2019

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BackgroundThe capacity of the UK GP workforce has not kept pace with increasing primary care workloads. Although many doctors successfully complete GP specialty training programmes, some do not progress to work in NHS general practice.AimThis article explores the training experiences and perceptions of newly qualified GPs to understand how their education, training, and early experiences of work influence their career plans.Design and settingA qualitative study of doctors in their final year of GP training (ST3) and within 5 years of completion of GP training (F5).MethodParticipants across England were recruited through training programmes, First5 groups, and publicity using social media and networks. Open narrative interviews were conducted with individuals and focus groups. Audiorecorded interviews were transcribed, and a thematic analysis was supported by NVivo and situational analysis mapping techniques.ResultsFifteen participants engaged in individual interviews and 10 focus groups were carried out with a total of 63 participants. Most doctors reported that training programmes had prepared them to deal confidently with most aspects of routine clinical GP work. However, they felt underprepared for the additional roles of running a practice and in their understanding of wider NHS organisational structures. Doctors wished to avoid unacceptably heavy workloads and voiced concerns about the longer-term sustainability of general practice.ConclusionStrategies to attract and retain enough GPs to support delivery of comprehensive primary care should consider how doctors’ early career experiences influence their career intentions. A coherent plan is needed to improve their preparation and increase confidence that they can achieve a professionally satisfying, effective, and sustainable career in NHS general practice.

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GPs: working harder than ever

Cited by 8 publications

References 6 publications

The global prevalence of turnover intention among general practitioners: a systematic review and meta-analysis

The global prevalence of turnover intention among general practitioners: a systematic review and meta-analysis

Workforce predictive risk modelling: development of a model to identify general practices at risk of a supply−demand imbalance

The influence of training experiences on career intentions of the future GP workforce: a qualitative study of new GPs in England

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