British patients face the shortest GP appointments and are least likely to see a doctor in person, an international study has found.
Researchers analysed data from an international survey of almost 10,000 GPs in 10 high-income countries, including around 1,000 in the UK.
They said the findings of the report, which also found GPs in Britain had the highest stress levels, and lowest job satisfaction, should ring “alarm bells” for the Government about the state of general practice.
The study, led by the Health Foundation, found Britain had the shortest appointment times, at 10 minutes, along with Germany. Sweden had the longest slots at 25 minutes, with average times of 20 minutes in Switzerland and the United States, and most countries averaging 15 minutes.
GPs in the UK and Germany were least happy about the amount of time spent with patients, with just seven per cent satisfied.
Satisfaction in other countries ranged from 9 per cent to 22 per cent.
The GPs in the UK reported far more use of remote appointments than any of the other countries examined, with just four in 10 taking place in person between February and September 2022.
The UK was the only country in the study where GPs reported doing the majority of their appointments by phone or person. GPs in Switzerland did 88 per cent of consultations in person, along with 86 per cent in the US, and 85 per cent in France. Official statistics for England show almost seven in 10 GP practice consultations taking place face-to-face, although this includes nurses.
GPs in Britain also thought patient care has suffered compared with before the pandemic, with half believing the quality of care they can provide has worsened and only 14 per cent thinking it has improved.
The study found UK GPs also had the lowest job satisfaction compared with those working in France, Germany, the US, Canada, Sweden, the Netherlands, Switzerland, Australia and New Zealand.
Unhappy about administrative work
Just a decade earlier, UK GPs were among the most satisfied of any country, the report said. Some 71 per cent of UK GPs said they found their job “extremely” or “very” stressful, up from 60 per cent in 2019 and the highest of the 10 countries surveyed.
More than eight in 10 GPs in the UK were unhappy about the amount of time spent on administrative work.
However, average working hours compared favourably to most of the countries examined.
While Australia and New Zealand reported the shortest average week at 37 hours, in the UK the figure was 39 hours. The longest hours were reported from Germany, at 53 hours, with family doctors in Switzerland, France, Netherlands, Canada, the United States all exceeding the average hours reported by the UK.
Professor Kamila Hawthorne, chairman of the Royal College of GPs, said the findings were “alarming, but not at all surprising”.
She said: “College research that has shown that two-thirds of GPs feel so over-stretched that they cannot guarantee safe patient care, and many cite workload and burn out as a reason they are considering leaving the profession.
“GPs and our teams want to deliver safe, appropriate and timely care for our patients, but with the intense workload and workforce pressures we are working under, this is becoming ever more difficult.”
Hugh Alderwick, director of policy at the Health Foundation, said: “The NHS is not the only health system under pressure, but the experience of GPs in the UK should ring alarm bells for government.
“General practice is the foundation of the NHS, yet GPs are telling us loud and clear that these foundations are creaking.
“The pandemic has taken a heavy toll on UK GPs, combined with longer-run challenges including staff gaps and rising workload.
“Just a decade ago, UK GPs were among the most satisfied of any country in the survey, but now they are the least satisfied alongside GPs in France.
“GPs are stressed out and burnt out – and many are considering leaving their jobs.
“Decisive policy action is needed to improve the working lives of GPs – including to boost GP capacity, reduce workload and make use of wider primary care staff.
“The Government has promised that its much-delayed workforce plan for the NHS will be published shortly, but the promise of new doctors will be little good if the NHS cannot retain the ones it already has.”
Despite repeated pledges to increase the number of GPs, the number of fully qualified, full-time equivalent GPs in England has fallen since 2015, according to data analysed by the Health Foundation.
GP shortages are estimated at 4,200 and could grow to 8,800 by 2031 – around one in four posts.
Dr Kieran Sharrock, acting chairman of GPC England at the British Medical Association, said: “These findings are unfortunately unsurprising; workload in general practice has become totally unsustainable and GPs are burning themselves out trying to keep up with rising patient demand. It really worries me that so many of my colleagues are reporting that they are stressed and burnt out.
“Many talented and experienced doctors are becoming disenchanted and feel as though they have no choice but to reduce their hours or leave the profession altogether, ultimately depriving communities of the care they need. We’ve now lost the equivalent of 2,078 fully qualified full-time GPs since September 2015.”
Record numbers in training
A Department of Health and Social Care spokesman said: “The number of doctors in general practice rose by over 400 in 2022 and is more than 2,000 higher than 2019 with record numbers in training.
“We are aware of the pressures facing GPs and we have recruited over 25,000 additional members of staff including pharmacists, physiotherapists, and paramedics, who are providing care directly to patients or supporting doctors and nurses to do so.
“We will announce further support soon with our primary care recovery plan and, as mentioned in the Budget, our long-term workforce plans.”
