Sustaining a career in general practice: a qualitative study of experienced GPs in South West England

General practice in the UK faces a growing retention crisis, with many experienced GPs reducing hours or leaving patient care amid rising workload and system strain. Understanding what sustains GP careers is crucial to stabilising the workforce.

To explore how experienced GPs' career intentions have evolved since the 2016 ReGROUP study and to identify factors influencing decisions to stay, reduce, or leave clinical work.

A qualitative interview study was undertaken with experienced GPs in South West England, and analysed using the Job Demands-Resources (JD-R) model.

We conducted 19 semi-structured interviews with GPs who had previously completed the ReGROUP survey. Transcripts were analysed thematically with input from public and professional stakeholders.

GPs described escalating clinical and administrative workloads, moral distress, and reduced control as key pressures driving burnout and exit. Hybrid access models, secondary care workload transfer, and punitive regulatory processes intensified strain. Retention was supported by clear workload boundaries, continuity of care, supportive practice systems, portfolio careers, and collective advocacy. Some GPs maintained engagement by reshaping their roles or practice structures to regain control and sustain meaning.

Retention depends not only on reducing workload but also on restoring the conditions that make being a 'good GP' feel possible, through continuity, manageable demand, and supportive organisational culture. Creating space for flexibility, autonomy, and role redesign may help sustain experienced GPs and strengthen workforce resilience.