Coping with General Practice: a mixed methods study

Background: This study focuses upon understanding the perceived pressures that General Practitioners (GPs) working in the National Health Service (NHS) in England face and the strategies which individuals use to cope with and manage these. There are increasing demands upon health care provision in the NHS. These relate in part to the increasing healthcare needs of an ageing population and are compounded by the emergence of new treatments and technologies. Additionally, there have been significant contractual, organisational, administrative, and regulatory changes for General Practice to accommodate at a time of financial constraint. These pressures have been recognised in reports by the Kings Fund (Baird et al., 2016) and more recently the Health Foundation (Fisher et al., 2020). There is a consistent pattern of increasing workload felt at the individual level occurring at the same time as both significant demographic changes in the GP workforce and increasing difficulties with recruitment and retention. GPs describe significant work stress, and research has described some of the individual and workplace attributes that may moderate this. GP wellbeing is recognised as important internationally. For the individual doctor, workplace stress and burnout contribute to ill health and lack of career engagement. These impact patient care, jeopardising its quality and safety (Hodkinson et al., 2022; Gunja et al., 2022). Although previous studies have considered those who have left the workforce, this study aims to identify and explore aetiological factors in GP stress amongst those currently in the workplace. Understanding these should assist in designing approaches to address the issues before doctors leave the workforce. Methods: A sequential mixed methods design underpinned by critical realism allowed for in-depth exploration of how GPs practicing in England perceive their working life. Initial qualitative interviews with GPs, considered how individual doctors framed their understanding of their working lives. The ...