Urgent action needed to retain doctors we have, GMC report says

The General Medical Council (GMC) is calling for urgent action to retain doctors who are leaving the profession in droves due to a ‘vicious cycle’ of unmanageable workloads and burnout.

In a new report, The state of medical education and practice in the UK 2023, the GMC has warned that many doctors are changing their working patterns, places of work or even re-thinking their careers because they increasingly feel unable to cope. In effect it creates a vicious cycle that threatens patient safety.

Findings show the number of doctors who reported working beyond their rostered hours on a weekly basis rose from 59% in 2021 to 70% in 2022, and 42% said they felt unable to cope with their workload each week (up from 30% in 2021). Just half said they were satisfied in their work, down from 70% in 2021.

Doctors with training responsibilities had more negative experiences than those who don’t, though both show a worsening picture. Half of trainers reported experiencing compromised patient safety or care (51%, up from 34% in 2021) compared with two-fifths of non-trainers (39% up from 26% in 2021).

More doctors than ever said they were likely to leave the UK workforce and had taken ‘hard steps’ towards doing so.

Need to retain doctors we have

Charlie Massey, the GMC’s Chief Executive, said: “More clinicians than ever are telling us they are taking steps to leave the profession, and the gap they could leave behind will only compound workload pressures and feed into a vicious cycle. It’s especially worrying to see the impact on trainers, who are critical for ensuring that our doctors in training develop the skills and confidence they need. Any government commitments to expand medical training places, whilst welcome, will flounder if the needs of the trainer workforce are not urgently met.

“Since any increase in medical school places would take many years to deliver new doctors, steps are needed now to retain the doctors we have. Without them, the vicious cycle will intensify, patients will suffer, and doctors will increasingly risk burnout and fatigue.”

The report suggests some immediate actions to help break the cycle, as well as longer-term strategic priorities that should be considered by healthcare leaders and policymakers. This includes:

• Ensuring doctors feel valued by their employers – a workforce that feels valued will be less likely to leave, ultimately having a positive impact on patient safety.
• Developing better and more consistent induction and onboarding – when a doctor joins a new workplace, it is important for there to be a thorough and ongoing induction into the new role.
• Developing flexible rota design – rotas should be fair and flexible and, where feasible, should take account of doctors’ personal circumstances and life events.
• Providing workplace rest and refreshment facilities – space for meaningful rest breaks, facilities for hot drinks and food, provision for parents and carers, car parking that is safe and subsidised or free.

In the longer term, the GMC wants to see increased training and better support for trainees and primary care doctors to protect patient safety and staff wellbeing. This should include considering how more trainee doctors can be encouraged to choose primary care as a specialism.

Findings are stark for GPs

The Medical Defence Union (MDU) has backed the GMC calls for immediate action to be taken to support dissatisfied and burned-out doctors and said that the findings were particularly stark for GPs.

Over half  of GPs (55%) are struggling with their workload. Worryingly 45% of GPs had experienced compromised patient safety or care, and 62% found it difficult to provide sufficient patient care each week.

Dr Caroline Fryar, MDU director of medical services added: “The NHS is facing enormous challenges including the increasing complex care demands of an ageing population and growing waiting lists for treatment post-pandemic. It can only overcome these with a properly resourced workforce that is well supported. The GMC’s latest report shows that this is far from the case. This is extremely concerning from the perspective of staff and patient safety.”

She said from their own survey it is clear that wellbeing among doctors is very low and that our members are really struggling. We need the actions identified in the report, such as flexible rotas, providing rest and refreshment facilities and addressing the pressures in primary care, to be taken without delay.

“We agree with the GMC that better inductions for staff need to be a priority. This is particularly important with nearly half (47%) of junior doctors joining the NHS being non-UK nationals. Doctors need a thorough onboarding process when starting a new role, so they properly understand the specific systems they are working in,” she said.