was 4B.4 - The changing general practitioner workforce: developing policies and strategies to retain the GP workforce (ReGROUP)

Problem

The UK faces major challenges in maintaining the general practitioner (GP) workforce. Demand for primary care is increasing, while a substantial proportion of experienced GPs are considering quitting direct patient care, or taking a career break; many of this latter group perhaps not returning to direct patient care, or with reduced time commitment. Given the long trajectory to train a GP, bolstering the workforce in the short term is essential. Preliminary research commissioned by the South West Academic Health Science Network to evaluate the workforce situation in South West England has fed into a large study, recently commissioned by NIHR HS&DR, to identify potential policies and strategies that may help retain the experienced GP workforce.

Approach

Our preliminary work included: 1) a rapid review of existing evidence to identify factors affecting GPs’ decisions to retire from direct patient care; 2) a survey of GPs in Somerset, Devon and Cornwall to estimate the proportion of GPs considering quitting within five years through early retirement or career breaks; 3) qualitative interviews with a sample of survey respondents who had recently, or who intended to take early retirement within five years and GPs who were on a career break; and 4) profiling local practices to identify those at risk of supply-demand imbalance through early retirements. Our NIHR-funded study will build on this methodology and develop and road-test potential policies and strategies in consultation with key stakeholders at regional and national level.

Findings

Existing literature evidenced factors associated with intentions to quit patient care, but there was sparse evidence on factors promoting retention of the workforce. GPs were surveyed from 142/306 practices across the South West with a response rate of 56% (529/984); GPs represented 82% (117/142) of sample practices. 35% of GPs intended to quit within five years (65% for GPs 50-59 year-olds). 22% of GPs intended to take a career break within five years, (30% of 31-39 year-olds). 69 GPs considering early retirement were willing to be interviewed, contact with 33 of whom yielded 20 interviews. 12 retired GPs identified by practice managers yielded 3 interviews. We were unsuccessful in interviewing GPs on a career break. Key themes from the interviews included: making the GP workload more manageable; managing change sympathetically; paying attention to GPs’ own health; improving confidence in the future of general practice; and improving GP morale.

Consequences

A high proportion of GPs, especially those aged 50-59 years, intend to quit direct patient care within five years. Our NIHR-funded study aims to gather data on a larger scale across the South West and identify feasible, acceptable policies to help retain experienced GPs in direct patient care.