Working lives of GPs in Scotland and England: cross-sectional analysis of national surveys

Helen Hayes, Jon Gibson, Bridie Fitzpatrick, Katherine Checkland, Bruce Guthrie, Matt Sutton, John Gillies, Stewart Mercer

Research output: Contribution to journalArticlepeer-review



The UK faces major problems retaining general practitioners (GPs). Scotland introduced a new GP contract in April 2018, intended to better support GPs. This study compares the career intentions and working lives of GPs in Scotland with GPs in England, shortly after the new Scotland contract was introduced.

Design and setting

Comparison of cross-sectional analysis of survey responses of GPs in England and Scotland in 2017 and 2018 respectively, using linear regression to adjust the differences for gender, age, ethnicity, urbanicity and deprivation.


2,048 GPs in Scotland and 879 GPs in England.

Main outcome measures

Four intentions to reduce work participation (five-point scales: 1=‘none’, 5=‘high’): reducing working hours; leaving medical work entirely; leaving direct patient care; or continuing medical work but outside the UK. Four domains of working life: job satisfaction (seven-point scale: 1=‘extremely dissatisfied’, 7=‘extremely satisfied’); job stressors (five point-scale: 1=‘no pressure’, 5=‘high pressure); positive and negative job attributes (five-point scales: 1=‘strongly disagree’, 5=‘strongly agree’).


Compared to England, GPs in Scotland had lower intentions to reduce work participation, including a lower likelihood of reducing work hours (2.78 versus 3.54; adjusted difference = -0.52; 95%CI -0.64 to -0.41), a lower likelihood of leaving medical work entirely (2.11 versus 2.76;

adjusted difference = -0.32; 95%CI -0.42 to -0.22), a lower likelihood of leaving direct patient care (2.23 versus 2.93; adjusted difference = -0.37; 95%CI -0.47 to -0.27), and a lower likelihood of continuing medical work but outside of the UK (1.41 versus 1.61; adjusted difference = -0.2; 95%CI -0.28 to -0.12). GPs in Scotland reported higher job satisfaction, lower job stressors, similar positive job attributes, and lower negative job attributes.


Following the introduction of the new contract in Scotland, GPs in Scotland reported significantly better working lives and lower intention to reduce work participation than England.
Original languageEnglish
JournalBMJ Open
Publication statusAccepted/In press - 6 Oct 2020


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