Much of the Health Secretary's plans to revamp the NHS depend on transferring services from overloaded hospitals, overcrowded beds to 'neighborhood health centres' where possible and to general practitioner clinics.
However, while Wes Streeting hopes to make it easier for patients to visit the doctor, thousands GPS surgical hours have been sharply reduced in recent years.
Only one in 13 aspiring GPs are now working full-time, according to the data. National Health Service numbers.
A Guardian analysis of official data found the typical GP works five fewer hours a week than in 2017. England fell by a third.
The figures, which do not include GPs in training or working as locums, show that doctors are increasingly choosing to work part-time. In September, only 7,480 people worked more than 37.5 hours a week, compared with more than 11,000 in 2017.
The change in reported hours was largely driven by young and middle-aged GPs at the start of their careers. Less than 8% of GPs aged 30 to 34 work full-time, down from 22% in March 2017. Similar declines were observed among people aged 35 to 40 and 40 to 44 years.
Newly qualified GPs appear not willing or able to work full time in the National Health Service. Dozens of GPs contacted the Guardian to explain why they had cut their hours or wanted to do so, with the majority of GPs earlier in their careers blaming unrelenting stress at work.
Yasmin*, a 29-year-old GP from Leicestershire, realized before completing her training that she had underestimated the pressure of her job.
“The pace was too much for me,” she said. “When you're always late from work, making decisions all day and dealing with people's constant anger about the service you offer, it's easy to feel resentful, as if you want to snatch your life from the ungrateful, unyielding clutches of the NHS and the wider public.”
Yasmin works two days a week as a GP. “I get paid for 16.5 hours, but I work about 22 because I come early, leave late and never take breaks,” she said. “The rest of the week I teach general practice residents. I'm already at my limit.”
Although most contract GPs work less than full time, the BMA says they may use additional unpaid hours to carry out administrative work, a point made by various respondents.
“Although on paper many GPs work part-time, in reality they work beyond their contracted hours,” said Joe, 33, from Brighton, who also works two days a week as an NHS GP.
“A full-time GP day is eight hours and 20 minutes, but my surgery is open to patients for nine-and-a-half hours and I can't remember the last time I had a lunch break. Add a couple of hours of paperwork and it's usually closer to 11-12 hours a day. It's very mentally tiring and I feel at high risk of burnout if I do it more regularly.”
However, a shortage of GPs is not the problem: while salaried GPs in all age groups are cutting their hours, many locum GPs are struggling to find work as practices employ fewer locums and salaried GPs due to NHS reforms which have led to budget constraints.
Lucy-Jane, an unemployed GP from Devon who will complete her training in 2023, was among a number of locum doctors who reported they were struggling to find work. despite millions of patients struggling to see their GP.
“The year before I qualified, there were still plenty of GP jobs available, but the work gradually dried up,” she said. “I feel like I'm on a scrap heap. Friends and family are shocked that I can't find work and everyone is talking about how desperate they are to see a GP.”
The total number of general practitioners has increased in recent years. A recent study in the British Medical Journal found that more GPs are in training but proportionately fewer are working in NHS general practice. More than a third of licensed general practitioners (19,900) have not worked in NHS general practice in 2024 – compared to 27% in 2015. Female doctors, junior GPs, UK qualified GPs and GPs in London and the South East were the most likely groups to be qualified but not work in the NHS.
The 49-year-old part-time GP from Somerset said three of her trainees emigrated to Canada shortly after completing expensive NHS training. “These are international graduates who came here to work but now, having qualified, find the NHS a hostile work environment and have moved to other countries with better work-life balance,” she said.
While many GPs who contacted us said they had cut their hours or quit due to overwhelming workloads, burnout or achieving a better work-life balance, many others, particularly older GPs, cited a lack of job satisfaction – a perceived inability to perform the job they were trained and signed up for – as the main reason.
Anne Mellor, 52, an NHS GP partner from Doncaster, said she plans to quit what used to be her “dream job” and retrain as a trainer or consultant.
“Over the past three years, I have reduced my working hours to part-time because changes forced upon ussuch as changes in funding and the need to work with other practices in primary care networks mean we provide an inferior service to our patients,” she said.
Recent reforms, she said, have reduced the number of available visits to local GPs, meaning patients now have to travel further to be seen by an unfamiliar locum doctor or nurse practitioner rather than a family doctor.
Some GPs who contacted us cited an inability to find comprehensive childcare as a reason for reducing their working hours. Others said they and many of their colleagues had cut their hours to qualify. for the government's proposal for free childcare.
“I'm older and started when working an average of 100 hours a week was a normal part of the job,” said Adam, a GP from the Midlands who was 50. “I work out four days a week now, but almost none of my younger colleagues work out more than three days. [to qualify for free childcare]”
One of the most frequently cited reasons for reducing work hours among older physicians was the motivation to avoid what many call punitive income taxes.
Andrew, 61, a GP from Norfolk, said he cut it to three-and-a-half days because the pension scheme allowed him to draw more than £3,500 a month from his pension while working. “I have more money, I work less. My patients will now have to wait longer to see me, and many will choose to wait to receive ongoing care.”
Many noted that tax breaks, which encourage the most experienced GPs to reduce their hours, had a significant impact on the quality of care patients received.
“We are an aging population and dealing with multiple comorbidities in one patient is a major challenge,” said a 51-year-old GP from the North West, who hopes to cut his hours to three days soon because “extended working hours are no longer in your financial interest.”
She said older GPs who move to part-time or retire early and are replaced by newly qualified part-time GPs, locums and low-paid health staff such as physiotherapists and nurses are part of a “gradual deterioration” of the system. This echoed the views of many other doctors.
“We need experienced doctors in the system to guide those who lack the experience to deal with all these patients with complex problems, otherwise the whole thing will collapse further.”
The total number of GPs has increased in recent years, despite the average GP reducing their working hours – meaning the total number of hours worked by qualified permanent GPs per week has fallen by less than 1% overall.
An NHS spokesman said: “Patients are seeing millions more GP appointments than before the pandemic and increasing the number of GPs remains a key priority for the NHS to help improve access to care.
“Almost 1,300 doctors have joined general practice in the last year alone, providing greater flexibility for GPs, including career portfolio support, helping to retain more staff and improve their working lives, while bringing additional skills into general practice.”
*Name has been changed
