New research from the Health Foundation adds strength to recent warnings from the BMA, the RCGP and individual GPs and Local Medical Committee chairs of a growing crisis in primary care.
The report Stressed and Overworked (drawing on the Commonwealth Fund’s 2022 International Health Policy Survey of Primary Care Physicians in 10 Countries) finds that a majority of GPs in all countries are dealing with higher workloads than before the pandemic – and many have experienced greater stress and signs of emotional distress.
Over half the GPs in most countries believe the quality of care their patients receive throughout the health care system has got worse since the start of the pandemic.
But it finds that British GPs are the most stressed, with a massive 71% saying that their job is ‘extremely’ or ‘very’ stressful, compared with 60% in 2019, before the pandemic.
And UK GPs are also the least satisfied with practicing medicine, with less than a quarter (24%) saying they were ‘extremely’ or ‘very’ satisfied, down sharply from 39% in 2019.
UK GPs are less satisfied than the nearest comparators, France and Germany, and 27% of UK GPs say they are ‘slightly’ or ‘not at all satisfied’.
The Health Foundation sums up:
“UK GPs are also among the least satisfied with practising medicine, work-life balance, workload, time spent with patients and other parts of their jobs. …
“The pandemic has taken a heavy toll, with UK GPs experiencing higher levels of emotional distress and bigger rises in workload than GPs in nearly all other countries. UK GPs are among the most likely to plan to stop seeing patients regularly in the next 1 to 3 years.”
63% of UK GPs say they have experienced emotional distress such as anxiety, great sadness, anger or feelings of hopelessness since start of pandemic – highest of all countries alongside New Zealand.
The low satisfaction level is no doubt also linked to the conviction that GPs are able to give less satisfactory care to their patients: “Half of GPs in the UK think the quality of care they can provide to patients has got worse since the start of the pandemic – and only 14% think it has improved.”
Part of the reason for poorer care to patients is more GP time soaked up by admin tasks and bureaucracy: more than 8 in 10 (83%) UK GPs said they were slightly or not at all satisfied with the amount of time they spend on administrative work, including 59% who are not at all satisfied.
The UK and Germany also have least time to consult with patients, averaging 10 minute appointments, while five other countries averaging 15 minutes, two countries 20 minutes and Sweden offers a generous 25 minutes.
However there are strengths: UK GPs are among the strongest performers in terms of using data to inform care, digital access, and in their preparedness to care for patients with chronic conditions, living with dementia, palliative care.
43% of GPs in the UK said they think the performance of the NHS is good or very good (down from with 60% in 2019), while 17% said the health service is poor or very poor (almost double the 9% in 2019).
The Health Foundation, presumably unaware of NHS England’s imposition of a new controversial contract on GPs, recommends policymakers to “recognise the strengths of general practice in the UK, and work with the profession rather than against it.”
The UK is the only country where GPs report doing a higher proportion of appointments by phone or video than in person, with the increase in telephone appointments a crucial component of the increased numbers of appointments delivered compared with pre-pandemic levels. The average GP in the UK reported conducting 40% of patient consultations in person, 55% by telephone and 5% by video.
The Health Foundation concludes by calling for more investment:
“Any long-term strategy for better supporting GPs should involve greater investment in wider public services that shape the health of their patients.
“Cross-government action is needed – for example, to improve living conditions and strengthen social security, alongside investment in the NHS and policies to improve care in more deprived areas.”
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