Observational studyBMJ quality & safety2023
Predictors and population health outcomes of persistent high GP turnover in English general practices: a retrospective observational study.
Observational study in BMJ quality & safety, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Fragmentation by design.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Attrition of the Midwifery Workforce: Understanding Factors Associated With Leaving the Profession.Health services research · 2026Article
- Understanding persistent GP turnover using work and personal characteristics: a retrospective observational study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Observational
- Supporting and Retaining NHS England Staff with Long-Term Health Conditions-A Qualitative Study.Healthcare (Basel, Switzerland) · 2025Article
- Evaluating a pharmacist-led cardio-renal-metabolic service to reduce healthcare inequities in a socioeconomically deprived population: a prospective intervention study.International journal of clinical pharmacy · 2025Article
- Patient characteristics and degrees of discontinuity of care in Danish general practice: a cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- What makes general practice work: the role of continuity in efficient and sustainable primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Strong Association of Perceived Chronic Stress with Leadership Quality, Work-Privacy Conflict and Quantitative Work Demands: Results of the IMPROVEBehavioral sciences (Basel, Switzerland) · 2025Article
- Article
- Emerging Domains for Measuring Health Care Delivery With Electronic Health Record Metadata.Journal of medical Internet research · 2025Review
- Impact of changes in primary care attachment: a scoping review.Family medicine and community health · 2025Article
- The incidence and prevalence of juvenile idiopathic arthritis differs between ethnic groups in England.Rheumatology (Oxford, England) · 2025Article
- Understanding access to general practice through the lens of candidacy: a critical review of the literature.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Review
- GP working time and supply, and patient demand in England in 2015-2022: a retrospective study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Observational
- Locum doctor working and quality and safety: a qualitative study in English primary and secondary care.BMJ quality & safety · 2024Article
- Older Adults' Experiences With Participation and eHealth in Care Coordination: Qualitative Interview Study in a Primary Care Setting.Journal of participatory medicine · 2023Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveEnglish primary care faces significant challenges, including 'persistent high turnover' of general practitioners (GPs) in some partnerships. It is unknown whether there are specific predictors of persistent high turnover and whether it is associated with poorer population health outcomes.
designA retrospective observational study.
methodsWe linked workforce data on individual GPs to practice-level data from Hospital Episode Statistics and the GP Patient Survey (2007-2019). We classified practices as experiencing persistent high turnover if more than 10% of GPs changed in at least 3 consecutive years. We used multivariable logistic or linear regression models for panel data with random effects to identify practice characteristics that predicted persistent high turnover and associations of practice outcomes (higher emergency hospital use and patient experience of continuity of care, access to care and overall patient satisfaction) with persistent high turnover.
resultsEach year, 6% of English practices experienced persistent high turnover, with a maximum of 9% (688/7619) in 2014. Larger practices, in more deprived areas and with a higher morbidity burden were more likely to experience persistent high turnover. Persistent high turnover was associated with 1.8 (95% CI 1.5 to 2.1) more emergency hospital attendances per 100 patients, 0.1 (95% CI 0.1 to 0.2) more admissions per 100 patients, 5.2% (95% CI -5.6% to -4.9%) fewer people seeing their preferred doctor, 10.6% (95% CI-11.4% to -9.8%) fewer people reporting obtaining an appointment on the same day and 1.3% (95% CI -1.6% to -1.1%) lower overall satisfaction with the practice.
conclusionsPersistent high turnover is independently linked to indicators of poorer service and health outcomes. Although causality needs to be further investigated, strategies and policies may be needed to both reduce high turnover and support practices facing challenges with high GP turnover when it occurs.
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