To be honest, this is something that's been happening for a while now.

Possible causative factors:

1. Fewer junior docs choosing to train in the NHS, let alone general practice. Of my year's cohort from hospital medicine (prior to specialisation), half had chosen to go abroad for six to twelve months on placement. About a quarter of them of chosen to stay permanently. Others are emigrating to Canada or NZ.

2. Revalidation. The amount of effort involved in revalidation means that those who are close to retirement are choosing retirement over continuing to work.

3. Micromanagement. Despite GPs supposedly being independent contractors, we're micromanaged to the nth degree. We're monitored on the number of appointments we offer, the amount of drugs we prescribed and which ones of each type, etc. It's getting to the point where a lot of GPs are getting fed up and leaving early.

4. Funding cuts. This doesn't mean pay but funding for things like nurses, blood tests etc. Despite expectations, GPs aren't paid to provide venesection for blood tests - it's not in the core contract. So normally, if you need a blood test, your GP gives you a form and you can take it somewhere to have your blood taken. Now some surgeries offer this out of their own pocket for patients' convenience. But when you're getting less and less money to provide core service, you start to cut non-core unpaid services. Remember that 90% of patient contact occurs in general practice and yet it receives only 9% of the NHS budget (down from 11-12% a few years back).

5. Pay cuts. Despite common depictions in the media, most GPs don't get "paid" a salary and it certainly isn't circa £100k. Most GPs are partners and hence they have drawings. The surgery gets money from various sources for doing various things. This is then used to pay utilities, cleaning, staff (pay + pension), etc. Of what's left, they have to pay for their own pension (both employer and employee contributions), indemnity, BMA/GMC/RCGP fees etc and then they may draw what's left. In some practices, GPs have to pay into the practice as they're losing so much money. Salaried GPs (like me) get a fixed pay for a fixed amount of work. Life's easier at times but you have no control over a lot of things.

6. The "me me me" generation of demand means workloads are going up. Patients want to be seen immediately for a sore throat they've had for a day, or a headache they've had for an hour but not taken painkillers for.

6. Daily wail/media/Govt bashing of GPs. Continual denigration of GPs means morale is low. Again, GPs are choosing to retire early or emigrate in preference.

7. Fewer docs going into general practice. This is down to a combination of the above.

Interestingly, this is what was happening a few years back. So GPs were offered "golden hellos" to join unpopular practices (ie remote or underprivileged areas), and the contract was rewritten so some things were more favourable. The difference is that GPs weren't denigrated back then and there wasn't so much of the "I want to be seen now".

I'd recommend everyone read this:
http://peterenglish.blogspot.co.uk/2013 ... times.html

The downside is that it won't reach the people who really should be reading it.