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

Abstract

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.

SciScore for 10.1101/2022.01.26.22269874: (What is this?)

Please note, not all rigor criteria are appropriate for all manuscripts.

Table 1: Rigor

Ethics	not detected.
Sex as a biological variable	All researchers were female, with non-medical backgrounds.
Randomization	not detected.
Blinding	not detected.
Power Analysis	not detected.

Table 2: Resources

No key resources detected.

Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:

Strength and limitations: This research provides rich and contextualised understanding of the experiences of a varied sample of GPs during the pandemic, which our recent systematic review (currently under review) identified as lacking from a UK setting. While there may be selection bias in the views expressed by GPs willing to share experiences, our interview findings are consistent with other international research and wider commentary on this topic. Our 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.33 Implications for research, policy and practice: This research demonstrates the effect of the pandemic on GP wellbeing, with potential wider impacts, for example around workforce retention and patient safety; highlighting a need for national and local intervention. Using Deci and Ryan’s self-determination theory17, a recent GMC report16 described the “ABC of doctors’ needs”, advising that doctors’ sense of autonomy, belonging and competence need to be promoted for them to thrive in their working lives. All three components have been threatened during the pandemic. GPs’ ability to control and influence their work has reduced, and patient frustrations and media blaming of GPs has affected their sense of belonging and competence. There is a need for policy to support GPs, prevent work stress and foster collaborations across ...

Results from TrialIdentifier: No clinical trial numbers were referenced.

Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

Results from JetFighter: We did not find any issues relating to colormaps.

Results from rtransparent:

Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
No protocol registration statement was detected.

Results from scite Reference Check: We found no unreliable references.

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