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GPs Report Hike in Workload and Stress Since the Pandemic

GPs in the UK are under "extreme strain" and public satisfaction with general practice has "plummeted", according to a health think-tank.

Although GPs around the world were contending with the impact of the COVID-19 pandemic on their patients and working lives, those in the UK reported higher levels of emotional stress and bigger rises in workload compared with counterparts in almost all other high-income countries, according to a new analysis by the Health Foundation.

The report analysed Commonwealth Fund data from a 2022 international survey of 9526 primary care physicians from the UK, US, Canada, Australia, New Zealand, Germany, France, Switzerland, Netherlands, and Sweden.

Stress Levels Among UK GPs Increased by 11%

The survey found that 71% of 1010 GPs in the UK who were polled reported that their job was extremely or very stressful, the highest proportion in all 10 countries, and comparable only to Germany at 68%. Stress among UK GPs was up 11% on the pre-pandemic 2019 figure.

In the UK, 4% of GPs said they felt completely burned out, 6% experienced persistent symptoms of burnout, and 30% reported one or more symptoms of burnout. Only 7% of UK GPs said they enjoyed their work and were without symptoms of burnout – similar to counterparts in Australia, where the figure was 8%, but significantly worse than the Netherlands, where 23% said they did not have any burnout symptoms.

The analysis found that since the start of the pandemic, a substantial number of primary care practitioners in all countries had experienced emotional distress such as anxiety, great sadness, anger, or feelings of hopelessness. GPs in the UK (63%) and New Zealand (61%) were most likely to have undergone emotional distress, while GPs in Switzerland were least likely (32%). Across all 10 countries, more female GPs reported emotional distress than male GPs.

Other key findings from the analysis included:

  • 35% of the UK GPs who find their work extremely or very stressful planned to stop seeing patients regularly in the next 1-3 years
  • The percentage of UK GPs who were extremely or very satisfied with practising medicine fell from 39% to 24% between 2019 and 2022, with only counterparts in France scoring lower
  • UK GPs were least satisfied with their administrative burden, workload, and time available to spend with patients
  • 50% of GPs in the UK think the quality of care they can provide has worsened since the pandemic, whilst only 14% believe it has improved a lot or somewhat
  • UK GPs reported providing a higher proportion of remote appointments than any other country

On a positive note, the UK performed well compared with other countries in regular use of data by GPs to inform patient care. The UK had the highest proportion of GPs who said they reviewed data on prescribing practice, patient hospital or emergency admissions, and patient-reported outcome measures wither quarterly or annually.

Survey fieldwork was conducted between February and May 2022. The authors cautioned that survey response rates were low, with only 22.4% of GPs in the UK responding.

'Alarm Bells Ringing'

The Health Foundation concluded that the experience of GPs in the UK, particularly regarding workplace stress, should "ring alarms for government". Despite repeated pledges to increase the number of GPs, the number of fully qualified, full-time equivalent GPs in England had fallen since 2015, it said, with current shortages of 4200 predicted to grow as high as 8800 by 2031, it said.

Hugh Alderwick, director of policy at the Health Foundation, said: "Decisive policy action is needed to improve the working lives of GPs – including to boost GP capacity, reduce workload, and make use of wider primary care staff. The Government has promised that its much-delayed workforce plan for the NHS will be published shortly, but the promise of new doctors will be little good if the NHS cannot retain the ones it already has."