Exploring the impact of COVID-19 on GPs' wellbeing

Background Chronic stress and burnout threaten the mental health of GPs, the quality of patient care and the sustainability of the health care system. Doctor burnout has been described as a public health crisis and in pre-COVID times, general practitioners had worryingly high rates of common mental disorders such as depression and anxiety and characteristics associated with burnout. There are clear additional risks to workforce wellbeing during COVID-19. GPs have experienced rapid change, risks of infection, remote working and reductions in face-to-face patient care. Some changes, however, could improve GPs wellbeing, including public gratitude, much-needed financial investment, e-consultations, improved cooperation and GPs returning temporarily to practice. Aims and Objectives This research aims to understand the impact of COVID-19 on the wellbeing of GPs, and to inform future policy during the recovery period, with the goal of improving resilience and retention of GPs. Further objectives are to: Understand experiences and intentions of those returning temporarily to practice Understand the perceptions of newly qualified GPs Explore the views of groups at risk of stress and burnout. Methods A mixed methods approach will be adopted, using three work packages (WPs) that will address complementary objectives. An umbrella literature review (WP1) will synthesise evidence on primary care workforce wellbeing during COVID-19. A systematic approach will be adopted to searching databases for published and ongoing studies, with authors contacted to avoid duplication. A social media analysis (WP2) will gauge GP sentiment around the impact of COVID-19 and explore how perceptions and experiences have evolved over time. A Twitter database using tweets relating to COVID-19 and including 30,000 doctors views will be used to extract data from UK GPs; analysed for quantitative trends in sentiment using key words and qualitative longitudinal analysis exploring a subsample of accounts in depth. Qualitative interviews (WP3) will provide a detailed and contextualised understanding of GPs views and lived experiences during COVID-19. While providing a general overview of experiences from 30-40 GPs, we will sample specific subgroups including those returning to general practice, GP trainees and First5 GPs and subgroups at greatest risk of stress and burnout. Interviews will last up to one hour, with variation across key characteristics such as age, gender, ethnicity, contract, regional prevalence of COVID-19 and socio-economic deprivation. Data will be analysed thematically through the process of Framework Analysis. Timelines for delivery The project will be nine months in duration, with WPs running concurrently and supported by multiple experienced researchers. Interim reporting is planned for Apr 2021 (WP1 and WP2), with final reporting by end July 2021. Anticipated Impact and Dissemination We will ensure research findings are disseminated swiftly to appropriate policy makers; enabled through our close links with DHSC, RCGP and NHSE&I. Interim reporting may aid policy decisions around GP appraisal processes, which are currently being considered, and potentially could support an evidence base for the winter wellbeing package under development by RCGP. We will adopt a varied dissemination strategy through written outputs in journal publications, blogs, editorials and presentations to local and national audiences.