One in three GPs say they plan to leave medical practice within five years, while patient appointments have risen 14% since 2019. This project will identify which personal factors—such as age, sex, and ethnicity—and which practice characteristics help keep GPs in their jobs, then turn those lessons into practical retention strategies. The problem is that most UK research has focused on recruiting new GPs rather than fixing the workplace conditions that drive experienced doctors away. Some practices retain staff far better than others, even in deprived areas, suggesting that organisational culture and support systems matter as much as individual burnout. If successful, this work could give GP practices a menu of evidence-based interventions—from flexible scheduling to peer support networks—tailored to different doctor demographics. Better retention would improve patient continuity of care, reduce practice closures in underserved communities, and help shift NHS services from hospitals into local clinics. The team will co-design these recommendations with GPs, patients, and policymakers, then test which options GPs actually prefer through a national survey.
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Research question How can information on personal and practice characteristics associated with stronger GP retention be used to develop policies to support future GP retention and wellbeing? Background Workforce challenges in general practice threaten patient access and NHS sustainability as practices struggle to retain doctors. Strategic goals to move care from hospitals to communities are limited by increasing patient demand and constrained workforce capacity. GP appointments have increased 14% since 2019, while GPs are reducing their clinical hours and a third express an intention to leave medical practice within five years. Practices are closing, often in deprived areas where health needs are greatest. Research into GP wellbeing and barriers to joining partnerships has identified several challenges and the importance of finding the 'right practice.' Some practices have notably better retention and workplace satisfaction, suggesting potential lessons for others. UK evidence has largely focused on recruitment, offering solutions targeted at GPs rather than the practices employing them, failing to address organisational or system factors. Practices need solutions that consider variation in individual needs alongside more general approaches to becoming better workplaces. Aims and objectives This research will identify what personal and practice factors are associated with GP satisfaction and retention, learning from positive examples to develop recommendations for strategies that could improve GP retention nationally. Objectives are to: Understand how individual characteristics and preferences influence turnover and satisfaction (WP1). Identify characteristics of practices that successfully retain GPs (WP2). Co-design workforce retention intervention(s) (WP3). Quantify GP preferences for intervention components (WP4). Co-develop and share retention strategies (WP5). Methods A sequential mixed methods design, incorporating 'positive deviance' and implementation science will study practices performing better under similar circumstances. WP1: DEFINING links and DETERMINING practices (Months 1-12): Analyse national workforce data to determine predictors of turnover. WP2: DISCOVERING strategies (Months 6-42): Undertake qualitative case studies at practices with low/high turnover (matched on other key variables) to explore organisational retention drivers through observations, interviews and online focus groups. WP3: DESIGNING interventions (Months 25-43): Use a nominal group method with key stakeholders to discuss findings and prioritise GP Retention Intervention(s). WP4: QUANTIFYING preferences (Months 43-58): Conduct a Discrete Choice Experiment testing GP preferences for intervention components via national survey. WP5: KNOWLEDGE MOBILISATION (Throughout): Developing tools through co-production work, building a GP retention network to share findings. By considering variations in GP characteristics (age, sex, ethnicity), this research will develop tailored and inclusive workplace recommendations. Patient, GP, workforce and policy stakeholders will be consulted throughout. Timelines for delivery The fellowship will be completed over six years, with sequential work packages and concurrent training. Anticipated impact and dissemination This research will enhance understanding of GPs' needs and inform retention interventions. Improved GP retention could improve patient care, continuity of care, public health and facilitate a shift of care into communities. Findings will be disseminated through journal publications, conferences, stakeholder events and through accessible formats (infographics, videos, animations). Dissemination platforms will include a project website, sharing via GP training organisations and stakeholder platforms.
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