Understanding persistent GP turnover using work and personal characteristics: a retrospective observational study

Rising GP turnover, declining participation rates, and growing workforce pressures threaten the sustainability of general practice. As policy shifts towards community-based care and workforce retention, understanding the job characteristics linked to high turnover is crucial.

To examine the relationship between practice-level persistent GP turnover and GP job satisfaction.

A retrospective observational study was conducted using linked national administrative data and survey responses for GPs in England.

Annual national GP workforce datasets were linked for 2013-2019 to calculate GP turnover, defining persistent high-turnover practices as those where over 10% of GPs left each year in three consecutive years. This information was merged with responses of individual GPs participating in the national GP Worklife Survey (GPWLS) in 2015, 2017, and 2019. Multiple linear regression analyses were used to relate work satisfaction components (including composite scores 'autonomy', 'belonging', and 'competence') to persistent turnover.

Among 2403 GPs, 8% worked in persistent high-turnover practices. After adjusting for covariates, these GPs reported significantly lower sense of autonomy, belonging, and competence in their roles, and lower overall job satisfaction, life satisfaction, and higher working hours. Notably lower scores were found for elements of the role related to GPs' sense of competence.

A clear relationship exists between GP job satisfaction and high turnover. The notable differences in experiences in some key work characteristics suggest targets for developing interventions supporting GP retention.