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Almost two-thirds of trainee GPs plan to work part-time just a year after they qualify because being a family doctor is so stressful, research shows. © Provided by The Guardian Photograph: RayArt Graphics/Alamy
Their intention to work two-and-a-half or three days a week threatens to exacerbate the NHS’s already acute shortage of GPs and make it even harder for patients to get an appointment.
The King’s Fund study found that 63% of trainee GPs in England plan to work no more than six four-hour “sessions” a week one year after qualifying. Family doctors say they do not want to work any more shifts than that because their jobs are so intense and the extra work generated by seeing patients, such as referral letters, means a four-hour shift actually takes six or seven hours.
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Fewer than one-third of trainees – only 31% – said they planned to undertake seven, eight or more shifts, which in general practice is regarded as working full-time. That is 10% fewer than those who said the same as recently as 2016 and is further confirmation of the pronounced and growing shift towards part-time working among family doctors.
“GP trainees tell us that half-day clinical sessions are rarely four hours and in fact are more six or seven hours once all they have seen all their patients and completed their administrative work, such as checking blood results, making referrals and following up with other [medical] professionals.
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“So six half-days can be a lot more than 40 hours in practice”, said Dr Beccy Baird, a senior fellow in health policy at the health thinktank.
The big increase in part-time working is laid bare in the results of the survey, which is the fifth time since 2016 that the King’s Fund has canvassed GP trainees’ future career plans. The trend is also gathering pace because “trainee GPs don’t want to be crushed by weight of work and have seen too many members of the profession coming under unhealthy levels of pressure”, she added.
In the research, which was conducted among 318 future family doctors, “GP trainees were clear that the intensity of their work is the key reason that they want to work fewer sessions than in the past.
“They tell us that this is important not just because of their own work-life balance but also because they can’t practice safely and effectively if they are working so intensely over very long days.”
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When trainees who planned to work less than full-time were asked why, 78% said “intensity of the working day”. The three next commonest explanations also involved the demands of their jobs. Two-thirds (67%) said “volume of administrative work”, 63% cited “work-related stress” and 61% specified the “long working hours” involved.
The thinktank asked survey participants how many four-hour sessions they intended to work one, five and 10 years after qualifying. The results showed that many of the next generation of GPs planned to undertake less and less direct contact with patients over time.
The proportion of trainees planning to work only three or four shifts after one year has risen since 2016 from 13% to 21%, after five years from 20% to 31% and after 10 years from 22% to 26%
Those planning to undertake no clinical shifts at all after a decade has risen from 1% to 8%, and the number of trainees intending to work five or six sessions a week after 10 years has halved in just six years, from 52% in 2016 to just 26%.
Many trainees plan to start doing some work in other areas of medical practice, such as sexual health, urgent care or end of life care, or in medical education along reduced hours as a GP.
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Prof Martin Marshall, the chair of the Royal College of GPs, said that family doctors were increasingly working fewer shifts “to safeguard themselves from burnout and protect their patients,” adding: “A burnt-out GP is not able to practise safely.”
The King’s Fund also found that fewer and fewer trainees want to become partners – a boss of a surgery – because of the huge responsibility involved.
On Thursday, the new health secretary, Thérèse Coffey, is due to set out a plan to tackle the growing crisis in the NHS ahead of what bosses and senior doctors fear will be a very tough winter in which whole areas of care could fall over.
A spokesperson for the Department of Health and Social Care said: “The health and social care secretary is focused on delivering for patients and has set out her four priorities of A, B, C, D – reducing ambulance delays, busting the Covid backlogs, improving care and increasing the number of doctors and dentists.
“There are nearly 1,500 more full-time equivalent doctors working in general practice now than 2019, a record number of students started training last year and we are spending £1.5bn to create 50m more appointments by 2024.”
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