Much has been written in recent months about the ‘crisis’ in general practice; a crisis that has been linked to difficulties in recruiting to and retaining the workforce, changing working patterns, increasing care demands, and bureaucracy in the system of care. The debate has rippled through the press,1,2 been the subject of discussion at conferences and in the pages of journals,3 as well as prompting a number of reviews.4–6 While rarely out of the headlines or journals, it would seem that there is more ‘heat than light’ in identifying a way forward.
SURVEY OF WESSEX GPs
This lack of clarity prompted us to seek the experiences of GPs and their views of working in general practice today, and to ask them to look ahead to the future. This article is based on an analysis of data gathered in Wessex by a survey of GPs (n = 1445) and interview of a purposive ‘key informant’ sample of seven,7 reflecting different ages, career stages, and role types. The latter were recruited by invitation through local GP and practice networks, and those participating consented to undertake semi-structured telephone interviews. Both datasets were thematically analysed, and a fuller description of this work can be found elsewhere.8
A recent article in BJGP by Abbt and Alderson3 argues ‘It’s not workload’, however the views expressed by our informants would challenge this. They described today’s general practice working environment as being very different to that of some 20 or 30 years ago. The lack of a well-defined career structure, alongside other influences, was seen as being a significant factor in GPs no longer seeking to be partners, especially those in the early stages of a career. This seems to have arisen as a result of the extended responsibilities that come …