Sustainable GP workforce: a Realist Review
- Principal Investigator: Sophie Park
- 1 November 2022 to 31 December 2024
- Project No: 593
- Funding round: FR4
There are not enough GPs in the NHS. This problem is worse in areas of the country where poverty and underinvestment in healthcare mean patients experience poorer health than wealthier regions. Encouraging more doctors to choose and continue in a GP career is a government priority. However, with many doctors reducing their working hours or retiring early, we need to look at how we support and retain the GPs we have, alongside enabling recruitment of new GPs.
Previous research has focused on individual level GP career choices. Less well understood is how organisation of work, systems and interactions within general practice, shape these ultimate career choices. We will use a broader approach to understand what factors within the healthcare system could enable a sustainable GP workforce to achieve effective and equitable patient care.
What will we do?
Our research aims to understand what is needed to attract and retain GPs in different settings and situations.
Over 15 months, we will read previous work (research articles, reports, policies, and other relevant materials) to find relevant evidence. We will build a picture called an ‘explanatory framework’ that will tell us what is needed to support GP recruitment (new GPs) and retention (keeping GPs in practice), suggesting the reasons doctors are leaving practice, distinguishing between what is true for all GPs and those that are context specific.
This review aims to identify features of the system that shape doctors’ decisions to leave the NHS. For example, how and when GPs interact with patients and other staff; organisation of appointments and tasks; equality, diversity and inclusion (EDI); nature and balance of work (eg clinical, administrative). We aim to produce recommendations about practical changes to the current system, to directly reduce the numbers of GPs leaving work and support a sustainable GP workforce for effective and equitable patient care.
How will this make a difference?
We aim to identify what encourages GPs to select and sustain a career in primary care for the long-term benefit of their patients, enabling future delivery of effective and fair general practice services. Our diverse PPI team and stakeholders will contribute to the content and format of outputs from the review. We will discuss the review findings and prioritise improvements to the system with public contributors, PPI and stakeholders (e.g. Health Education England, General Medical Council). Patient involvement will ensure any changes we propose are both positive for patient care and acceptable to patients and carers. Our stakeholders will clarify what is possible based on the review findings, in terms of system-level recommendations for changes in local and national policy. Recommendations will include a detailed description of each change, including the evidence for why it is viable.
Amount Awarded: £186,226