Trends in full-time working in general practice: repeated cross-sectional study

Problem

There is little evidence and no agreement on what constitutes full-time working for general practitioners (GPs). This is essential for workforce planning, resource allocation and accurately describing GP activity.AimTo clarify the definition of full-time working for general practitioners, how this has changed over time and whether these changes are explained by GP demographics.

Approach

Design and SettingRepeated cross-sectional national surveys between 2010 and 2021.MethodComparison of three measures of working time commitments (hours and sessions per week and hours per session) plus a measure of workload intensity across survey years. Multiple regression to adjust the changes over time for age, sex, ethnicity, contract type, area deprivation, and rurality. Unadjusted hours and sessions per week were compared to definitions of full-time working.

Findings

ResultsAverage hours and sessions per week reduced from 40.5 (95% CI: 38.5, 42.5) to 38.0 (36.3, 39.6) and 7.3 (7.2, 7.3) to 6.2 (6.2, 6.3) respectively between 2010 and 2021. In 2021, 54.6% of GPs worked at least 37.5 hours per week and 9.5% worked at least 9 sessions. Hours per session increased from 5.7 (5.7, 5.7) to 6.2 (6.2, 6.3) between 2010 and 2021. Partners worked more hours, sessions and hours per session. Adjustments increased the increase in hours per session from 0.54 to 0.61.

Consequences

Conclusion At the current average duration of sessions, six sessions per week aligns with the NHS definition of full-time hours. However, hours per week is a more consistent way to define full-time work for GPs.