Influences on GP coping and resilience: a qualitative study in primary care

Background: ‘Neoliberal’ work policies, austerity, NHS restructuring and increased GP consultation rates provide the backdrop against increasing reports of GP burnout and a looming shortage of GPs.

Aim: To explore GPs’ experiences of workplace challenges and stresses and their coping strategies, particularly focusing on understanding the impact of NHS workplace change.

Design: Study design was qualitative, with data collected from two focus groups and seven one-to-one telephone interviews.

Method: Focus groups (n=15) and interviews (n=7) explored the experiences of currently practicing GPs in England, recruited through convenience sampling. Data were collected using a semi-structured interview approach and analysed using thematic analysis.

Results: Interviewees understood GPs to be under intense and historically unprecedented pressures, which were tied to the contexts in which they work; with important moral implications for ‘good’ doctoring. Many reported that being a full-time GP was too stressful: work-related stress led to mood changes, sleep disruption, increases in anxiety and tensions with loved ones. Some had subsequently sought ways to downsize their clinical workload. Workplace change resulted in little time for the things that helped GP resilience: a good work life balance and better contact with colleagues. Whilst some GPs were coping better than others, GPs acknowledged that there was only so much an individual GP could do to manage their stress, given the external work issues they faced.

Conclusion: GPs grasp their emotional lives and stresses as being meaningfully shaped by NHS factors; resilience building should move beyond the individual to include systemic work issues.