Doctors suffered a massive reduction in morale last year – with GPs especially hard hit, according to the findings of a major survey published today.

The findings show a “vicious cycle” of pressures that aggravate workforce shortages – leading to more pressure, the General Medical Council warned.

The survey found that 44% of doctors reported finding it hard to provide sufficient care “regularly” last year. This compared with 25% in the pandemic years of 2021 and 2020.

The proportion of doctors taking specific steps to leave the NHS doubled last year – from 7% to 15%, while the proportion of doctors satisfied with their work fell to 50% last year, a 20 percentage point reduction. The proportion of GPs saying this fell from 51% to 38%.

The GMC report, historically, examines the state of education and training – and it now finds that trainers are suffering badly. 51% reported experiencing compromised care and 18% said they were not supported by senior medical staff. This analysis shows the support available to doctors is crucial in morale, mental health and ability to maintain standards of care. The latest findings are based on a regular survey of about 4,000 doctors.

Its recommendations for trainees include consistent induction and on-boarding, flexible and fair rota design and workplace rest and refreshment facilities. It calls for long-term efforts to increase training capacity and build confidence and autonomy for trainees. This means not “constantly” relying on them to “plug gaps”.

There needs to be strengthened support for primary care and “more sustainable” work intensity for all doctors, the GMC says.

GMC chief executive Charlie Massey said: “More clinicians than ever are telling us they are taking steps to leave the profession, and the gap they could leave behind will only compound workload pressures and feed into a vicious cycle. It’s especially worrying to see the impact on trainers, who are critical for ensuring that our doctors in training develop the skills and confidence they need. Any government commitments to expand medical training places, whilst welcome, will flounder if the needs of the trainer workforce are not urgently met.

“Since any increase in medical school places would take many years to deliver new doctors, steps are needed now to retain the doctors we have. Without them, the vicious cycle will intensify, patients will suffer, and doctors will increasingly risk burnout and fatigue.”

The Royal College of GPs said the phrase “vicious cycle” is increasingly accurate. Chair Professor Kamila Hawthorne said: “Today’s findings from the GMC are a stark reminder of the workforce crisis facing general practice and the wider NHS, but sadly, they come as no surprise.

“The bottom line is, we need thousands more GPs, but the numbers are going in the wrong direction. However, it is not too late to turn this dire situation around. The long-awaited NHS workforce plan is the opportunity to make sure general practice is fit for the future.”

The British Medical Association warned of the “largest exodus” of doctors in NHS history.

Workforce lead Dr Latifa Patel said: “In 2021, 17% of doctors were at a high risk of burnout and this jumped to a quarter in 2022. I dread to think what the rate will be for 2023. Year-on-year pay cuts, chronic staff shortages, undoable workloads, poor workplace practices and environments, and subsequent poor job satisfaction has all resulted in over 15% of our NHS doctors taking hard steps to leave our NHS. These are not threats but rather show that doctors are putting plans in place to leave – the Government cannot afford to let this happen.

“The Government must treat this report from the GMC as a final call for it to deliver on the Long-Term Workforce Plan.”