'Vicious cycle' must be broken to tackle NHS workforce crisis, GMC warns
Urgent action is needed to break a ‘vicious cycle’ of unmanageable workloads, dissatisfaction and burnout that is causing UK doctors to take steps to quit, the General Medical Council (GMC) has warned in a report published today.
The regulator says 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.
The stark warning is in the GMC’s report The state of medical education and practice in the UK 2023, which includes data about doctors’ workplace experiences and the effects they are having.
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.
"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."
Chief Executive, General Medical Council
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.
Actions the GMC believe can quickly deliver benefits include:
- Making sure 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.
Longer-term priorities suggested in the report include:
- Making work intensity more sustainable – there is a clear need to increase overall capacity to deliver patient care.
- Increasing training capacity – doctors need to be encouraged and motivated to take on training responsibilities, and then need to be supported and have protected time to train others.
- Building trainees’ confidence and autonomy – trainee doctors need time set aside to develop their competences and confidence. They cannot be constantly relied on to plug gaps in a struggling workforce.
- Strengthening support for primary care – pressures in general practice need to be addressed 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.
Charlie Massey added:
‘Addressing these concerns, and improving doctors’ wellbeing, requires concerted action across the UK healthcare system. We are committed to playing our part in that endeavour, and what this report tells us should also bolster the resolve of others to tackle both the immediate and longer-term challenges the profession and the health system face.’
To find out more, including previous reports, visit The state of medical education and practice in the UK.