Thousands of NHS GPs are cutting their hours despite plan to increase access to doctors | GPs

Much of the Health Secretary’s plans to reinvent the NHS rely on moving services from bed-saturated and overburdened hospitals to “neighborhood health centers” where possible, and to general practice.

However, while Wes Streeting hopes to make it easier for patients to see their doctors, thousands of GPs have significantly reduced their surgery hours in recent years.

According to NHS figures, only one in 13 early-career GPs now work full-time.

An analysis of official Guardian data found that the typical GP is working five hours less a week than in 2017. The number of people working full-time in England has fallen by a third.

The figures – which exclude GPs in training or working as locum doctors – show that doctors are increasingly choosing to work part-time. Just 7,480 people worked more than 37.5 hours per week in September, compared to more than 11,000 in 2017.

The change in reported hours is mainly due to younger and middle-aged GPs at the start of their careers. Less than 8% of GPs aged 30 to 34 work full time, compared to 22% in March 2017. A similar decline was seen among 35 to 40 year olds and 40 to 44 year olds.

Newly qualified general practitioners appear being unwilling or unable to carry out a full-time week of clinical work in the NHS. Dozens of GPs have contacted the Guardian to explain why they have reduced their hours or are looking to do so, with most early-career GPs blaming the relentless stress of the job.

Yasmin*, a 29-year-old GP from Leicestershire, realized even before completing her training that she had underestimated the pressures of her job.

“The pace wasn’t sustainable for me,” she said. “When you’re always late to leave work, making decisions all day and dealing with people’s constant anger about the service you provide, it’s easy to feel resentful, as if you want to wrest your life away from the ungrateful and unyielding clutches of the NHS and the general public.”

Yasmin works two days a week in the role of clinical GP. “I get paid 16.5 hours, but I work about 22 hours because I come in early, leave late and never take a break,” she said. “The rest of the week, I teach general practitioners. I’m already at my limits.”

While most GPs work less than full-time by contract, the BMA says they could be spending unpaid overtime on administrative tasks, an argument which was raised by several interviewees.

“While many GPs work part-time on paper, in reality they work beyond their contracted hours,” said Joe, 33, a GP from Brighton who also works two days a week as an NHS GP.

“A full day as a GP is eight hours and 20 minutes, but my practice is open to patients for nine and a half hours, and I can’t remember the last time I took a lunch break. Add in a few hours of paperwork, and it’s usually approaching 11 to 12 hours a day. It’s very mentally exhausting, and I feel at high risk of burnout if I had to do it more regularly.”

The lack of GPs is not the problem, however: while salaried GPs across all age groups have reduced their working hours, many locum GPs are struggling to find work as practices hire fewer locum doctors and salaried GPs due to NHS reforms which have led to budget constraints.

Lucy-Jane, an unemployed GP from Devon who completed her GP training in 2023, was among many locum doctors who said they were struggling to find work despite millions of patients struggling to see their GP.

“The year before I graduated there were still plenty of jobs in general practice, but the work gradually dried up,” she said.

“I feel like I’m on the scrapheap. My friends and family find it shocking that I can’t find work, and everyone says how desperate they are to see a GP,” she said.

The total number of general practitioners has increased in recent years. A recent study in the British Medical Journal found that more GPs are being trained, but proportionately fewer are working in NHS general practice. More than a third of registered GPs (19,900) were not working in NHS general practice in 2024 – up from just 27% in 2015. Female GPs, young GPs, UK-qualified GPs and London and South East GPs were the groups most likely to be qualified but not working in the NHS.

A 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 are now qualified and finding the NHS a hostile working environment and have moved to other countries with better work-life balance,” she said.

While many GPs who contacted us said they had reduced their working hours or quit due to unsustainable workloads, burnout or to achieve a better work-life balance, many others, particularly older GPs, cited lack of job satisfaction as the main reason – the perceived inability to carry out the work they had been trained and signed up to do.

Anne Mellor, 52, a partner at NHS GP from Doncaster, said she was considering leaving what was once her “dream job” and retraining as a coach or advisor.

“I have reduced my hours to part-time over the last three years because the changes imposed on us, such as funding changes and being forced to work with other practices within primary care networks, mean we are providing a worse service to our patients,” she said.

She says recent reforms have reduced the number of appointments available with local GPs, meaning patients now have to travel further to be seen by unfamiliar locum doctors or nurse practitioners instead of their family doctor.

Some GPs who contacted us cited the inability to find comprehensive childcare as a reason for reducing their hours. Others said they and many of their colleagues had reduced their working hours to qualify for the government’s free childcare offer.

“I’m older and started working 100 hours a week on average, which was a normal part of my job,” said Adam, a GP from the Midlands in his 50s.

“I now work four days a week, but almost none of my younger colleagues work more than three days. [to qualify for free childcare].

One of the most cited reasons for older GPs for reducing their working hours was the motivation to escape what scores describe as punitive income taxation.

Andrew, 61, a GP from Norfolk, said he had fallen to three and a half days because the pension system allowed him to withdraw more than £3,500 a month from his pension while working. “I have more money by working less. My patients will now have to wait longer to see me, and many will prefer to wait to benefit from continuity of care.”

Many have pointed out that tax incentives that encourage more experienced GPs to reduce their working hours have substantial effects on the quality of care patients receive.

“We are an aging population and dealing with many co-morbidities in a patient is a major issue,” said a 51-year-old GP from the north-west who is looking to reduce to three days soon because “working more hours is no longer in your financial best interest”.

Older GPs leaving part-time or retiring early and being replaced by newly qualified part-time GPs, locums and lower-paid health staff such as physiotherapists and nurses, she said, were part of the “progressive deterioration” of the system, echoing the views of many other doctors.

“We need experienced clinicians in the system to guide those who lack the expertise to treat all of these complex patients, otherwise everything will collapse even further.” »

The overall number of GPs has increased in recent years, even though the average GP has reduced their working hours – meaning the total number of hours worked per week by qualified permanent GPs has fallen by less than 1% overall.

An NHS spokesperson said: “There are millions more GP patient appointments than before the pandemic, and increasing the number of GPs remains a key priority for the NHS to help improve access to care.

“With almost 1,300 more doctors added to general practice in the last year alone, providing greater flexibility for GPs, including supporting portfolio careers, helps to retain more staff and improve their working lives, while bringing additional skills to general practice.

*The name has been changed