General practitioner wellbeing during the COVID-19 pandemic: a qualitative interview study

Background

Workload pressures and poor job satisfaction have been reported by UK general practitioners (GPs) for some time. The COVID-19 pandemic presented new challenges, with growing international evidence of its negative impact on GPs’ mental health and wellbeing. While there has been wide commentary on this topic, UK research evidence is lacking. Developing greater understanding of these lived experiences and subgroup differences is important as doctor wellbeing may affect the sustainability of health care systems and quality of patient care.

Objectives

To explore the lived experience of UK GPs during COVID-19, and the pandemic’s impact on their psychological wellbeing.

Design and Setting

In-depth qualitative interviews, conducted remotely by telephone or video call, with NHS GPs.

Participants

GPs were sampled purposively across three career stages (early career, established and late career or retired GPs) with variation in other key demographics. A comprehensive recruitment strategy used multiple channels. Data were analysed thematically using Framework Analysis.

Results

We interviewed 40 GPs; most described generally negative sentiment and many displayed signs of psychological distress and burnout. Causes of stress and anxiety related to personal risk, workload, practice changes, public perceptions and leadership, teamworking and wider collaboration and personal challenges. GPs described facilitators of their wellbeing, including sources of support and plans to reduce clinical hours or change career path.

Conclusions

A range of factors detrimentally affected the wellbeing of GPs during the pandemic and we highlight the potential impact of this on workforce retention and quality of care. As the pandemic progresses and general practice faces continued challenges, urgent policy measures are now needed.

Strengths and limitations of this study

• While there is growing international evidence base demonstrating the impact of the COVID-19 pandemic on GPs’ wellbeing and much UK media coverage, this qualitative interview study provides much-needed research evidence of UK GPs’ lived experiences and wellbeing during COVID-19.

• 40 GPs were sampled purposively to include GPs with different demographic and practice characteristics.

• While there are no easy solutions to the problems highlighted, this research provides increased contextualised understanding of how these experiences may impact future workforce retention and the sustainability of health systems longer-term.

• Sub-group differences by gender and age are reported; highlighting a potential need for further research and support targeted at specific groups.

• Findings are necessarily limited to the time of data collection (Spring/Summer 2021); further tensions in general practice have since arisen, particularly regarding negative and misleading media portrayal.