There are several reasons for the shortage of GPs.

• Fewer medical students are opting for a career in general practice.
• In addition, the GP workforce is ageing, especially in inner city areas where it is much harder to recruit and retain doctors.
• In addition, increasing numbers of experienced doctors over the age of 50 are considering retiring, or quitting patient care within the next five years.
• There are also now more women than men opting to train as GPs. A high proportion of these doctors will take a career break, with a significant proportion not returning to the workforce or returning part time. A recent NHS report has recognised this imminent crisis and recommended urgent action to understand the reasons for the loss of both experienced GPs and those taking a career break.
• In addition, the general population is ageing with increasingly complex health needs placing additional demands on GP time. Shortage of GPs will thus put patients at risk and exacerbate inequalities in care.

As it takes at least 10 years to train a GP, recruiting more GPs is not an immediate solution, and understanding how we can retain the existing workforce is essential. This research aims to gain insight into the problems of GPs quitting direct patient care through retirement or taking a career break, and will help provide strategies and policies for the NHS in seeking to maintain the GP workforce.

This research consists of six projects.

1. First, we will conduct a systematic review of existing literature to find out what evidence already exists about GPs decisions to quit direct patient care.
2. Second, we will conduct a survey of GPs in South West England to identify those considering early retirement or taking a career break and to help identify GPs for our qualitative research.
3. Third, we will carry out interviews with experienced GPs aged 50-60 years old who are intending to, or who have already quit direct patient care, and with GPs who have taken, or who are thinking about taking, a career break. These will allow us to develop our understanding about why GPs decide to leave face to face patient care. The results from the literature review and interviews will allow us to develop some policies and strategies that might be expected to encourage GPs to stay in direct patient care.
4. Fourth, once we have identified these policies and strategies, we will ask a panel of experts, including commissioners, GPs, practice managers, and PPI representatives to review, and prioritise the policies.
5. Fifth, alongside this research programme we will develop computer models that will help us identify which general practices may be “at risk” in terms of maintaining their GP workforce over the next five years. Thus, the policies and strategies we have developed through our research could potentially be targeted at the practices most likely to benefit from them.
6. Finally, we will consult with key stakeholders responsible for planning the GP workforce to find out whether they think the policies and strategies are acceptable to practices and healthcare planners, and to comment on whether they would be taken up within a short enough time to be helpful. PPI representatives will play a critical role in reflecting on whether patients are likely to find the policies and strategies acceptable.

December 2016

Following our last update in September, we have been very busy over the last few months, and we’d like to share with you an update of what’s been happening within the ReGROUP project.

The systematic review is now complete. It focuses on the factors that influence GPs’ quitting and career break decisions. Our final report that goes along with it is also on the way to completion.

Our survey generated a great response rate of 67% of all GPs (nearly 3,500) in the South West. The results have now been written up and we are anticipating that they will be published imminently!

Recruitment for people to take part in our qualitative interviews is now finished and analysis of these interviews is well underway.

We have now recruited the RAM expert panel. They will begin rating our draft policy statements in January, looking at the feasibility of each statement and how likely it is that they could be implemented into practice. The information that has been used to generate the policies and strategies has been obtained from input gained through the qualitative work and the systematic review.

Our modelling work, centered around supply and demand on GPs over the coming years (based on information from the survey and qualitative work), is nearly complete and will be written up in the New Year.

We are currently planning the national stakeholder consultation meetings. The aim of these meetings will be to present the drafted policies and strategies rated most highly by the RAM expert panel. We are looking for key stakeholders to take part in the meetings and will be sending out invitations soon – so keep an eye on your inboxes!

We look forward to updating you again soon but in the meantime we wish you all a very merry Christmas.

The ReGROUP research team

September 2016

Our research is progressing well. We have nearly completed a systematic review of the literature around factors influencing GPs’ quitting and career break decisions and also administering a large-scale survey of all GPs in South West England. An impressive 67% of GPs responded to the survey, which will help us establish an estimate of the proportion of GPs who intend to permanently quit direct patient care and/or take a career break within the next 5 years. We are enormously grateful to all who gave their time to respond!

We are currently in the process of conducting interviews with a number of GPs who returned the survey and also with others involved in general practice workforce planning here in the South West. The aim of the interviews is to identify potential content that can be used to structure policies and strategies that could support experienced GPs to remain in direct patient care.

In addition, our Patient Public Involvement group have supported the systematic review work, by feeding in their views on the literature and providing comment on the content of the emerging report.
Our next stage will involve recruiting an expert panel comprised of members of key stakeholder groups with expertise in workforce planning to give their views on the proposed policies and strategies that we will shortly draft following the completion of our first three workstreams.

Programme of work
We are committed to completing this research in less than two years as follows:

We look forward to updating you again soon!

The ReGROUP research team

Please click the link to complete our GP Workforce Questionnaire.

Qualified GPs registered on the NHS England Performer’s List in South West England have been invited to complete a brief online survey to indicate the likelihood of leaving or taking a break from direct patient care within the next 5 years.

All replies will be confidential, published survey data will be anonymised and we will not report or publish any individual-level or practice-level identifiable data, or release such data to anyone outside of the research teams at the Universities or Exeter or Bristol. To encourage participation, we are offering all participants entry into a prize draw: five winners will each receive a Kindle.

A sub-sample of those considering taking a break or leaving direct patient care, and those who have already left or are on a career break, will be invited to be interviewed (you can complete the questionnaire without consenting to interview). Interviews will take place face-to-face or by telephone on a mutually agreed day and time. Interviews will last no more than 30-60 minutes and will be completely confidential. You would be financially reimbursed for your time.

Why do GPs leave the workforce?

The University of Exeter Medical School has been commissioned by the National Institute for Health Research to investigate the factors contributing to GPs’ decisions to leave direct patient care (leading to career breaks or early retirement/retirement before the age of 60).

It is widely recognised that England faces a significant and imminent problem in respect of GP workforce capacity. Some GPs are considering leaving the clinical workforce, and in some places, fewer newly qualified doctors are choosing a career in general practice. There is potential for an important imbalance in the demand for primary care and the capacity to deliver it.

The ReGROUP study aims to explore GPs’ decision-making about taking a break from or leaving direct patient care, and possible ways to facilitate GP retention.

Contact us

If you have any queries, please do not hesitate to contact the researchers directly:

Project Manager, Emily Fletcher: e.fletcher@exeter.ac.uk, 01392 722 826

Researcher, Dr Anna Sansom: a.sansom@exeter.ac.uk, 01392 726 189

The RAND/UCLA Appropriateness Method (RAM) Panel is being formed as part of the ReGROUP study to assess the appropriateness and feasibility of policies and strategies for retaining GPs in direct patient care. This part of the research uses a well-established and internationally recognised technique to rate statements or criteria for appropriateness in clinical practice and health policy settings. The level of agreement is used to inform the next stages of development and the stakeholder consultation taking place later in 2017.

Our panellists have been invited from a wide range of GP practices and stakeholder organisations. We have selected the panellists based on their role in managing GP practices and/or their expertise in GP workforce development and retention. The RAM Panel members will receive a summary of the evidence and will be asked to participate in two rounds of online rating exercises. In the second round, they will be shown the group level responses for the first round and asked to review their first response. The median and level of agreement is used for reporting the results from the RAM process.

Why do GPs leave the workforce?

The University of Exeter Medical School has been commissioned by the National Institute for Health Research (NIHR) to investigate the factors contributing to GPs’ decisions to leave direct patient care (leading to career breaks or early retirement/retirement before the age of 60).

It is widely recognised that England faces a significant and imminent problem in respect of GP workforce capacity. Some GPs are considering leaving the clinical workforce, and in some places, fewer newly qualified doctors are choosing a career in general practice. There is potential for an important imbalance in the demand for primary care and the capacity to deliver it.

The ReGROUP study aims to explore GPs’ decision-making about taking a break from or leaving direct patient care, and possible ways to facilitate GP retention.

Contact Us

If you have any queries, please do not hesitate to contact the researcher directly:
Researcher: Rupa Chilvers 
Project Manager: Emily Fletcher