Background GP retention is a serious issue. Despite recent increases in patient volume and demand, workforce numbers have failed to adapt. Between 2005 and 2014 the number of GPs leaving almost doubled, and nearly half of those intending to leave are under the age of 50; if uncorrected, this poses a sustainability issue for the NHS.

Aims The aim of this study was to explore the perceptions and views of GPs regarding GP workforce retention.

Methods Six GPs were sampled by convenience sampling, and underwent semi structured telephone interviews in March 2018 of up to an hour.Interviews were transcribed by the researcher and analysed thematically using the six step approach by Braun and Clarke.

Findings There were five themes and ten subthemes. Themes were: increasing and changing patient expectations, consultation changes, system pressures, lack of leadership and culture. The ten subthemes were lack of patient education, increased patient consumerism, time pressures, restricted practice, breakdown in doctor patient relationship, non-primary care pressures, administrative pressures, government interference, organisational culture and workforce culture change.

Conclusion A breakdown in doctor patient relationship, increased patient consumerism and limited resources provided by the government, coupled with the less vocational workforce culture of newer GPs, have all contributed to a desire to leave practice. A lack of leadership opportunities for GPs was found to negatively affect job satisfaction due to reduced autonomy and opportunities to impact upon decision making. Formal leadership training could be developed, which has been shown to increase engagement with leadership in clinical commissioning groups and reduce the conflict of values that a hybrid clinical-leadership role brings. Other ways towards increasing leadership without detracting from clinical work would be to create leadership fellow positions and advisory posts, to ease GPs into these roles.