To ask if GPs are leaving NHS and why?

[CloudyYellow]

Seems like numbers are going down and it sounds like the job is unsustainable.

Force them to work 5 days and watch then all leave then

So a 24 hour week, or a 36 hour week. The GPs I know work a minimum of 12 hour days (apart from Saturday shifts that are generally 8).

I'd rather see a doctor than someone who has done a 2 year postgraduate course to fill a role no one really knows the parameters of but was created to be a cheaper way to fill gaps of actual qualified and suitably trained doctors thanks. The fact they get paid double that of a junior doctor is frankly insulting as well.

Most of the older GPs retired after COVID. They’ve not been replaced.
2/3 of current GP trainees in a recent research paper stated that they have no intention of EVER working full time. A large number said they have no intention of working in the UK either. So we are paying circa £50k for people to be trained to do a job they have no intention of doing. similarly, medical students will be trained here at great expense and then will be off somewhere else to work.

This is due to pay and conditions. If you treat people like crap then they won’t do it. It’s a crazy situation when we pay millions to train people to do a job and then can’t treat them well and pay them sufficiently to try and keep them here to do that job. And no-this isn’t necessarily Tory bashing-this is successive governments whichever side of the house they are.

Did you hear the health secretary this week saying; “well, what do consultants do on the weekend? We should get them in working!” No-you should pay and employ MORE consultants so that a weekend service would be viable-but don’t forget you’d also need more nurses/GPs/OTs/physios/
porters/support staff etc etc

And no-they don’t all get paid £125k and no, the pension is also not worth it as it once was because the government are now coming after consultants for their pension pot and have decided to tax them on it before they reach retirement despite the fact that they have already paid tax on that money when they earned it before it went to their pension. So many doctors are now getting surprise tax bills of £75k for their pension subscription. This is leading to doctors taking earlier retirement before their pension pot gets too large. End result-no older wiser doctors to mentor the new ones, leading to more stress and challenge for those newly qualified. Et voila-Madness.

@Guitarbar That's a very old fashioned view when most of the big cases require a MDT. If your talking about medicines hatred of PAs most of them come from BMS degrees (which is now causing staffing issues for labs but that's a whole other argument) who share the core modules with medicine others have significant post graduate experience as nurses etc. It would be interesting if we let other members of the NHS team sit the final year medicine exams I'm sure many nurses etc could pass them with flying colours as they have learnt the content over many years services vs in a lecture theatre, the problem with that approach would be the staffing to do clinical placements for them to upgrade their degrees.

It's not an old fashioned view, just sick of a medicine being devalued and degraded as a professional and people willing it along to save a bit of money. It's putting patients at risk, not that people care as long as PAs get to play doctors.

Poor work-force planning going back decades is a major background factor - there was a particularly large cohort of GPs reaching retirement age over the last 10 years and insufficient new GPs trained to replace them

I suspect more Physicians Assistants, telemedicine and overseas recruitment was the plan to fit this gap

So this bit was entirely foreseeable and the mitigation was insufficient

I have done 16 different medical/surgical specialties since I graduated med school - including ones thought of as hard/emotionally taxing. A&E, Palliative Care, ITU, Paeds, Acute Medicine, Psych, Oncology. Ones with brutal shift work rotas, overwhelming demand, high risk patients etc
GP is BY FAR the hardest, most soul destroying and exhausting specialty I've ever done and the people who do it are also often viewed with such disdain.
It's relentlessly awful. It's really lonely too. It's just almost unexplainably crap.

There are too few medical school places, demand is already very high and most applicants are rejected. That's the real problem. We've not trained enough for decades

yep

Of course the real elephant in the room is the aging and sick population with no proper care strategy. That is essentially collapsing the health service.

yep

I’m a recently qualified GP and have only been working as a GP for a few months and I can’t see how I can sustain it long term. Already looking into other options inc private/alternative careers/locum.

the job is relentless and you just get unhappy and thankless patients.

an average day includes:
50-70 patient contacts
20-30 blood/imaging results to action
15 documents to action (which can be complex things like new cancer diagnoses)
30 prescription requests to action
plus all the extra tasks/queries that come through from patients/staff!

we get 10 mins allocated for face to face appointments and inevitably patients expect and deserve more than this so leads to us always running late. This further annoys patients.

we get regular complaints because patients are unhappy with the service of which many aspects are out of our control, such as:

• strict referral criterias from hospital meaning we can refer majority of patients
• we no longer have any access to things like CT/MRI/heart scans so patients can’t get what we think they need
• long waiting lists for hospital appointment (most a year or more where I am).
• any many many other issues!

at the end of the day I’m frazzled, stressed and exhausted. Honestly when another patient complains I feel broken. then you look on social media and see another post on social media/mumsnet about how crap GPs are and how they’re not seeing patients.

one of my colleagues at another close practice recently committed suicide due to her work as a GP and I’m not willing to risk my life.

burnout is rife and we aren’t protecting our doctors. I have trained in UK and loved medicine but the realities of everyday GP is grim. Things need to change. We need more GPs, more protection and more respect.

Be sure its hellish working for the NHS. .y GP went to Sustria. Ingersoll say and great working balance.
I only managed it because I e been working there for 41 years and have become accustomed and hardened to the stress. They call us lifers.
If I was new I'd run away screaming.

*"I'd rather see a doctor than someone who has done a 2 year postgraduate course"
*
Yes so would I if given the choice - but the reality is that if I'm unwell and I want to get an appointment it's better to have the option of a PA or nurse than no care at all.

Lost so many that went back to their countries after Brexit.

Yes I don't live in a big place but personally know 2 german doctors who went home because of brexit

so that repeated all over the country

My sister is a GP - it is definitely about stress and money. I asked her about it recently and how things were going in her practice and she is completely overloaded and doesn't have time to treat people the way she would like to treat them (thoroughly).

She has offers all the time to go to private health companies and is considering it.

She feels bad for doing so, mostly because the NHS is treated like a religion and there is a tacit expectation she should work extra for free out of the goodness of her heart.

I know a married gp couple who retired a few years ago in their mid fifties, big practice at the edge of London.
My gp has just retired, aged 68, from a big practice in a city in Ireland.
Losing working age staff, in good health, with excellent pensions they say, can't help?

I'd happily see a nurse, a PA though no thank you. Nothing personal against them, but their training is not fit for the purpose in which they are being utilised.

The biggest factor right now is pension tax.

@Neanov nurse practitioners and paramedic practitioners are not band 4

Lots of outpatient based specialties like mine will be losing work to the private sector in the future. I can’t account for work conditions but a lot of these companies are offering huge salaries for routine work. I am seriously considering switching to one if I ever approach the dreaded lifetime allowance for my pension. These places can pay over 150k a year a salary thar can take a some time to get to once you are a consultant sticking to 10pas. They will expect more out of you and can be run efficiently.

Go and see how many same day private GP appointments you can get online. It's not a problem if you have the money. Those GPs are coming from somewhere.... I suspect more and more are mixing NHS and private work.

I'm a GP. Burnout is the determining factor. Older GPs are retiring as early as they possibly can. Younger GPs are moving abroad/going part time or choosing not to specialise or take on a partnership or salaried role as it's the only way they can handle the pressure. It's a relentless slog of too much work to do and too many patients to asses safely even if you're prepared to basically live at the surgery. On top of this, GPs are being demonised by the media. A result of this is a massive increase in complaints and borderline antisocial/unreasonable demands. This wouldn't be so bad if your governing bodies were on your side. Complaints are handled in a way that totally favours the patient and takes no account of the individual doctor's situation or the presssure they're under. It is focussed entirely on criticising the individual doctor and refusing to acknowledge any sort of insitutional failure even though the reality is that there is almost always at least an element of this contributing. It isn't even a question of the job being palteable any more tbh it's a question of personal safety. You're mentally exhausted and doing your best but you still might get sued or worse a manslaughter sentence any day. It really is a mess. I love the work I do but if there was an easy way for me to leave I would.

Amongst many reasons, because they can! If a GP is aged 55+ there is no financial reason to continue working - they have probably reached the lifetime allowance cap for pension contributions (a big problem in the NHS) and they can take their pension and live a stress-free life. I mean, why shouldn't they? They have given 30 years to the public sector, so good for them.

Force them to work 5 days and watch then all leave then

That’s not the answer either but when the government keep talking about extra GPs or increases they don’t mention that most aren’t full time.

Gordon Brown did just that, in an attempt to retain doctors however it meant that GP's were able to work part-time or retire early.

I work for the NHS and I agree with Adam Kay in that you don't need straight A's, you're not training as a scientist, they need to drop the grade requirement to B's and you'll get a good quality of candidate, and then train them as doctors. en-gb.facebook.com/Channel4News/videos/if-you-want-to-be-a-doctor-its-just-have-you-got-loads-of-as-and-are-you-good-at/865236930608215/