GPs leaving the UK

[Traveller3367]

DP is a HCP with lots of doctor friends.
In less than 2 years, 6 GPs have left the UK to work abroad (or are imminently leaving).
I read in the papers that 1 GP can care for upto 2000 patients so that's 12000 patients who have lost out.
AIBU to think there must be something about job that's driving them away?
The papers make it out to be easy and well paid but clearly not easy/well paid enough for some to stay and do it!
How can we keep our GPs in the UK to help us?

You don't need a gp referral for a dentist appointment or a pair of spectacles, so why do you need one to get NHS hearing aids or NHS glasses at Specsavers?

  ??? I've never heard of anyone needing a GP referral for NHS   eye tests or NHS glasses.

IMHO it’s not a case of who is to blame

The NHS when created post WW2, is not the same due to medical advances, people living longer, higher expectations and an increase in population

People expect the NHS to cure all ills, sorry, it can’t

Life expectancy has risen dramatically with better health care education etc, yes I know it’s not perfect but better than it was post WW2

Money is not everything but the NHS needs a radical overhaul to reflect the current situation and reduce waste, duplication

It is a sacred cow that politicians of all colours won’t touch due to it being a sacred cow and the political fall out ie votes at the GE

I have experience of the Australian medical system

All I will say is “Thank you NHS for a reciprocal agreement ”

There is so much nonsense and false information regarding what GP's do, work and get paid!
People are comparing NHS GP partners, to salaried Gp's to locums. Its like comparing a newly qualified teacher to a superhead - obviously someone is going to chip in that their 'friend' is on over 100K and spends 10 weeks a year on the golf course.

The reality is NHS employed GP's train for at least 7 years (5year MBBS, £45K, plus 2 year Registrar post) to start on a basis wage of £60,000 for an 8 session week of about 50 hours. The public moan about GP provision, the papers moan about entitled, rich GP's, you cannot provide the service that the job trains you to do safely. The whole system needs an overhaul or GP's will continue to leave the UK or retrain.

Over the past 15 or so years the UK population has risen. Number of GPS gone up or down in that time?
End result is more people unwell struggling to see a doctor at the starting point of getting better.

Our GP is very near the bottom of that list. The phone system does not work. The main partners left after a scandal and it's mostly part time locums.

Is there a recommended ratio of patients to GP?

@Ellen888
My GP friends tell me that the problem is the 15 min consultation, the lack of clinical autonomy and excess paperwork.

As a lay person. That sounds at the heart of the problems to me, and another case of technological measurement capability superseding human autonomy, to negative effect.

@neverbeenskiing

OP you only have to spend 5 minutes on MN to see why GPs are leaving. Everyone hates us. I’m working harder than I’ve ever worked but it’s still not enough. I’m leaving as soon as I can.

Not everyone. I've had a lot of contact with my local GP practice over the past 12 months due DS and I both developing some health issues. I've never struggled to get an appointment when I've needed one (including at the height of the pandemic) and we have been treated efficiently and with great kindness by every GP we've seen or spoken to. Like Teaching and Nursing being a GP is one of those jobs that many people seem to feel confident they know the reality of, and are therefore entitled to criticise, despite never having done it themselves. I'm not sure why that is. But for the sake of balance I just wanted to share a positive experience and for all the HCP's on this thread feeling demoralised. For every person who comes on here and bashes GP's I'm sure there will be others like me who are grateful for what you do. Its just that angry voices tend to be the loudest.

The problem is lack of consistency between GP surgeries and areas. There's no doubt some GP surgeries are managing things well, but others are pretty abysmal. There should be some way of ensuring consistency across the board, after all, all are working to the same rules/guidelines and receiving the same pay structure for their services, so there should be some consistent monitoring/enforcement of basic service levels to ensure consistency.

@threecee

Why is it there was no problem in march 2020 ? why has it only become a huge Drama since they were expected to get back to work ? everybody cant have emigrated since march 2020 ! it just seems so convenient to tack this crisis on to the covid restrictions what a god send to the BMA its been !

There was already. The government was already making wild promises about how many new GPs they were going to train. 2020 was a dreadful winter for the NHS before Covid kicked off. It was already on a downward trajectory and Covid has just made everything worse.

They asked for our help 5 years ago. They warned us this would happen.

Now here we are.....

Traveller3367 What did you do to support them 5 or so years ago?

I live in the Middle East and the majority of new doctors I come across now are British. 10 years ago there were never any at all. I think it's a combination of the fact there is no system to work with in the UK and racism in the UK. All my doctors are British Muslim.

Just to add they don't use phrases like watch and wait or you don't need any medicication/treatment now they are not forced to ration Healthcare

The problem is lack of consistency between GP surgeries and areas.

In terms of quality of care, there is no evidence that is the case.

There can't be consistency when some GPs are covering multiple surgeries and others are just managing 1.

The GP covering their own will be on site every day and seeing patients as well as calls. The GP covering 2 or 3 sites will be only on site 1 or 1.5 days and then covering calls from all practices each day.

I am a GP who has left, not for another country but I have changed career completely to a non medical field.

I cannot begin to tell you what a miserable job it has become. Even in the 10 years I was qualified, the job changed beyond recognition, due to chronic underfunding and understaffing. Ridiculously long hours, spent working full throttle doing 10 minute appointments (and yes, that's to read the notes, get frail patients to totter to the room and sit down / undress, see and examine the patient, and write up the appointment notes, before moving straight on to the next patient). Repeat x40 per day, with the pressure to continue to think clearly and make safe decisions whilst exhausted. Naturally, with a complex and aging population, very few things fit into a 10 minute slot. I was often 'running behind' and taking abuse from the patients coming after for that. Add on top of that a mountain of blood and investigation results to interpret, making referrals and responding to documents, reauthorisation of prescriptions (approximately 80 a day per Dr where I was) home visits, meetings, learning, managing staff who are often in tears from the abuse they take at the front desk, teaching junior doctors and medical students.

The pay is roughly 10k a session per year (a session is a half day). Its very difficult to work more than 3 days a week without completely burning out due to the hours, pressure and emotional toil. You then need to subtract from that the ridiculous indemnity fees (which were vastly more than my mortgage per month), subscription fees, GMC fees, etc etc.

I graduated literally top of the class from a highly esteemed UK medical school, and also have a further science degree. I excelled in my GP training. I really loved science and I really loved medicine. The NHS stamped every last ounce of it out of me and I now work in a completely unrelated non medical field, where I am treated with respect and I have the time to actually speak to the vulnerable people I help. I don't regret the time I spent as a GP as it was a privilege to help people at their most vulnerable, nomatter the toll it took on me personally. Never again thought would never advise my children to go to medical school.

*though

@Awalkintime
Well there's very little an individual can do but I do try

1. I didn't vote Tory
2. Try to use the pharmacy and buy my meds for conditions that I can (eye infections, piles etc)
3. Educate those around me that the GP is not for free paracetamol / multiple problems in one consultation / letters for housing etc
4. Comply with receptionists who as about my reasons for needing a doctor as I appreciate they have had training about what is suitable and not

Tbh I don't know what else I can do

@TinkysWinky your story saddens me. Seems like we lost a good caring GP. Hope your new job is fulfilling and less stressful

@Traveller3367 thank you. Yes it is not as academic but equally fulfilling and much less stressful all round. Make no mistake, my story is one that is currently being echoed in GP surgeries across the country. Many, many good, conscientious clinicians are on the brink of throwing in the towel. Of course, this is ideal for the Tory government, who would love nothing more than to be able to blame GPs for the privatisation of the NHS, which in reality is due to chronic under funding and under staffing under Tory policy. They have triggered a domino effect, from which I am sad to say I feel there is little chance of going back. We will naturally struggle to recruit and retain good, caring, experienced GPs to the NHS under these conditions. But without further recruitment, the cycle continues. Don't be sad for me as an individual - I am happy in my new role, and as I have said, I don't regret the time and training I spent or the people I helped during their lowest moments. Be sad for the NHS and those I never got to meet.

I should say, I always wanted to be a GP, all through medical school, I did a GP elective, went straight into GP training after the foundation years. It wasn't a 'backup' choice for me. GPs are hugely skilled consultants in family practice and please don't ever forget that and accuse them of being 'just' a GP. That used to hurt particularly.

I'm a GP. We just want to be able to close our list and say "this is as many patients as we can handle safely" but we can't do that and practices are getting unsafe numbers of patients allocated who then complain because they can't get an appointment. The system is stuffed.

cjpark £60k pa for 50 hours a week is still a decent salary compared to what most people earn. At least when it's compared to other professionals it's comparable. Everyone thinks lawyers earn a shit load. The average is about £40k for 50 hours a week. You could argue that being a GP is more important but so are a lot of people's jobs. The real issue seems to be the paperwork which I agree is a problem.

I compare conditions for these key workers, including doctors, paramedics and nurses with the comfortable, relaxed practices for those civil servants, lawyers, management consultants, accountants etc, etc, etc who are now working from home and demanding late starts, lots of breaks to enable them to do school runs.

I’m not sure you can conflate civil servants who have notoriously cushy positions with the other professions you mentioned that are notoriously ruthless and stressful.

Traveller3367
No I meant what DID you do when they asked for help 5 years ago? They were asking for our help 5 years ago. They said working conditions were appalling 5 years ago. They said many would leave 5 years ago. They predicted this loud and bloody clear!

What did you do THEN or did you ignore it? Did you support them and push your MP to make changes and pointing out the impact on the individual and the country as a whole if nothing was done? Or did you say - well if its that bad then leave? Or did you turn on the TV, see the campaign and ignore it and think its all hot air. If you ignored it then well then you reap what you sow. You contributed to it by ignoring drowning workers.

@Dogknowsbest

cjpark £60k pa for 50 hours a week is still a decent salary compared to what most people earn. At least when it's compared to other professionals it's comparable. Everyone thinks lawyers earn a shit load. The average is about £40k for 50 hours a week. You could argue that being a GP is more important but so are a lot of people's jobs. The real issue seems to be the paperwork which I agree is a problem.

For the amount of responsibility we take and the amount of abuse we take? When a senior manager in Aldi is on over £100k per year? Good luck finding highly qualified professionals with transferable skills to work for that money.

@daimbarsatemydogsbone And yet thousands of people continue to come, wanting to work and set up lives here. The Uk has among the highest living standards in the world.
I don't know about the GP situation. I get that it's a stressful job with long hours, but so are a lot of other jobs. No one is going to pay someone £60k a year (minimum) to do an easy 9-5. And they don't even have to do nights or weekends. But it's a free market, if they can get a better deal abroad then it's understandable they'd go.
It's the same as what's happening in the country my parents are from (lots of the doctors and nurses come to the UK and Germany). They feel they get a good ideal in the Uk, so it's all relative I suppose.