Skip to main content

Impact of reductions in primary care funding on the composition of the physician workforce

A well-established primary care sector has allowed England’s National Health Service (NHS) to make efficient use of resources through the gatekeeping role that general practitioners have in controlling access to specialist services. Because of the poor economic situation in the United Kingdom, there is now considerable pressure on the NHS to use its resources more efficiently. These financial challenges are putting enormous pressure on general practices at a time when the NHS is also going through other major structural changes. Consequently, general practitioners in England increasingly find themselves having to make difficult decisions about the future of their practices.

In an article published in the Journal of Ambulatory Care Management, I discuss the impact of these financial challenges on the career intentions of physicians. In recent years, primary care has been an attractive career choice for young physicians because of the flexible, diverse nature of the work and the relatively high-income levels that established general practitioners can receive. However, unlike specialist physicians, who typically receive a fixed salary, general practitioners’ income is very dependent on their practice budget, workload, and expenses. With workload increasing and income levels decreasing, many younger physicians—who might previously have chosen a career in primary care—may now choose instead to train in a different specialty. Older physicians may choose to retire rather than work in this much more difficult environment. What impact austerity will have on the primary care workforce is therefore of great concern.

You can read another version of this article at the BMJ's Doc2Doc Blog.

Comments

Popular posts from this blog

Example ADHD Referral Letter

Dear Dr, I am writing to refer a 28-year-old male patient of mine, Mr [Patient's Name], for assessment for the diagnosis and treatment of Attention Deficit Hyperactivity Disorder (ADHD). After a thorough clinical assessment, I believe that Mr. [Patient's Name] meets the criteria for adult ADHD as outlined in NHS guidance for primary care teams in SE London. Mr [Patient's Name] has been under my care for XX years and, during this time, he reports several symptoms (greater than five symptoms in total) consistent with ADHD in adults that have been present for more than six months. These symptoms include difficulties in focusing, following through on tasks, hyperactivity, forgetfulness, impulsiveness, restlessness, and irritability. Mr [Patient's Name] also reports being easily distracted, struggling with time management, organisation, and completing tasks efficiently. Many of Mr [Patient's Name]'s symptoms have been present since he was under 12 years old; and have

Dr Curran and Partners – Clinical Update 10 August 2023

1. Measles The UKHSA has warned that unless MMR vaccination rates improve, London could experience a large measles outbreak. Measles is potentially a very serious illness with important complications - but is preventable though vaccination.  Please ensure patients and their families are up to date with their vaccinations. Please also check the vaccine status of new patients - particular migrants - and enter details onto the medical record of any vaccines given elsewhere. https://www.gov.uk/government/news/london-at-risk-of-measles-outbreaks-with-modelling-estimating-tens-of-thousands-of-cases 2. Shingles vaccination The shingles vaccine programme is being expanded. From September, GP practices will offer: - Those aged 70-79, 1 dose of Zostavax or 2 doses of Shingrix - People aged 50+ with a weak immune system, 2 doses of Shingrix - Those turning 65 & 70, two doses of Shingrix vaccine. For further details, see https://www.gov.uk/government/publications/shingles-vacc

Why we need to put an end to the GANFYD culture in the UK

One of the causes of increased workload in general practice are the many requests that doctors get for letters, reports and forms from patients or from external organisations. It’s now so common that doctors have coined a term for it: GANFYD – Get A Note From Your Doctor.  It’s seems that large sections of society can’t function without these “letters from doctors”. Instead of using common sense or employing their own clinical advisers, external organisations make repeated requests to NHS doctors for letters which are often not at all needed. Often the worst offenders come from the public sector – e.g. universities who seem to look upon NHS general practice as a source of free occupational health advice for their students. Universities never – of course - offer to pay for this advice they get from NHS GPs. Instead, university requests will come with a mealy-mouthed statement that any fee is the responsibility of the student. Like doctors are going to impose heavy fees on impoverished s