Research

Workplace wellbeing for the general practice workforce across England: mapping current services

Lorna Hardy, Daniele Carrieri, Alex Aylward, Karen Mattick, Geoff Wong and Jane R Smith
BJGP Open 25 August 2026; BJGPO.2025.0169. DOI: https://doi.org/10.3399/BJGPO.2025.0169

Abstract

Background The rising prevalence of poor workplace wellbeing in healthcare practitioners has been defined as a global crisis, threatening the sustainability of healthcare systems and the quality of care. General practice staff in England are especially impacted, yet it is unclear how support for this workforce is delivered, and where accountability for this sits.

Aim To map the provision of wellbeing strategies and interventions for the general practice workforce in England.

Design & setting Survey and review of grey literature in contemporary England general practice.

Method We sent Freedom of Information (FOI) requests between 28 February 2025 and 12 March 2025 to all integrated care boards (ICBs) in England. We also sought existing information sources via targeted searches (for example, of professional organisation websites) and through engagement with relevant stakeholders, who also guided our methods, analysis, and dissemination.

Results All 42 ICBs in existence at the time responded to the FOI request. Responders’ roles and responses varied widely, including the extent to which general practice staff wellbeing was seen as the responsibility of the ICB and whether or what wellbeing services were offered. We identified 139 wellbeing services available to general practice staff via the FOI and 53 via the targeted searches. In total, 79 of the services were reported as being primary care staff-specific. Most services appeared to be reactive and aimed at the individual level.

Conclusion This is the first study mapping workplace wellbeing services for the general practice workforce across England. Our results suggest there is an interest in staff wellbeing. More preventive approaches addressing systemic workplace wellbeing factors are now needed. Future research should evaluate the impacts of wellbeing support for the general practice workforce.

How this fits in

Staff in general practice experience poor workplace wellbeing but the setting has received less workplace wellbeing research and policy focus than hospitals. It is not clear how support for this workforce is currently offered. This is the first study to map workplace wellbeing support for the general practice workforce across England. Our findings suggest that most services are reactive (address problems after they have arisen) and target individuals. More preventive approaches that address systemic workplace wellbeing factors are now needed.

Introduction

The rising prevalence of poor wellbeing in healthcare practitioners is a critical issue in England and other countries. It has been referred to as a ‘global crisis’1 given the strong link between workplace wellbeing, care provision, patient satisfaction, and broader organisational performance.2,3

General practice in England has been more affected than other settings owing to a combination of cumulative individual, occupational, and broader sociocultural factors; for example, frequent changes in the organisation of primary care; increasing administrative tasks and workload, which have changed the professional–patient relationship; and erosion of professional autonomy and values.4–8

However, primary care as a sector, and specifically general practice (see Table 1), has received less focus than hospital settings in terms of research and associated policy related to workplace wellbeing.9 Moreover, most research in this area to date has focused on GPs, with only some studies focusing on primary care nurses;10 this has been to the exclusion of other professional groups (for example, physiotherapists and paramedics), who are increasingly working in general practice.11 These other staff groups are important to consider also in light of the expansion of new healthcare worker roles into primary care, supported in England by the Additional Roles Reimbursement Scheme (ARRS) introduced in 2019,12 which allows primary care networks (PCNs) to claim reimbursement for the salaries of new roles within the multidisciplinary team. Some roles have not been well defined or integrated, and staff in these roles have faced unique challenges,13 which may be detrimental to professional and personal wellbeing.14,15 In the future, impacts on wellbeing may be further compounded by recent restructures to NHS England and integrated care systems (ICSs).14,16

View this table:
Table 1. Glossary and list of relevant organisations and bodies

It is important to strengthen support for general practice staff to protect patient safety and staff wellbeing. There are systematic reviews in progress evaluating the effectiveness of interventions to improve the work-related wellbeing and retention of primary care practitioners.17,18 However, in England, it is unclear how workplace wellbeing support is currently set up, and how it may change in the future. This study aims to address this important gap by mapping the provision of staff wellbeing strategies and interventions for the general practice workforce in England.

Method

First, we sent Freedom of Information (FOI) requests to all integrated care boards (ICBs) overseeing ICSs in England to understand any strategies and interventions currently provided at national, regional, and local levels. Second, we identified existing relevant information sources on wellbeing support services. Third, we engaged with stakeholders and drew on their relevant experiences and expertise19 throughout the research to inform our approach and ensure we were aligned with primary care staff’s concerns and needs in relation to workplace wellbeing.20

Stakeholder involvement

This study was supported by an advisory group including GPs, nurses, practice managers, directors of primary care, academics and researchers in this field, and patients. Stakeholders met online three times (the number of stakeholders per meeting was 10–17) during the 9 months of the project and were consulted on the research methods, analysis, and outputs, and on the dissemination of findings.

Freedom of Information (FOI) requests

FOI requests were submitted to all 42 ICBs in England at that time via email between 28 February 2025 and 12 March 2025. Data collection preceded the announcement made on 13 March 2025 that ICBs should reduce costs by 50% by the third quarter of 2025–2026.16 To ensure that the information we sought was not already publicly available, the NHS England FOI request archive was checked before submission of our request, with the keyword ‘wellbeing’, the topic defined as primary care, and the timeline defined as from 2017 onwards. No relevant results were found. Development of our FOI request (for full text see Supplementary Data 1) was informed by a number of resources,21–23 refined with our advisory group, and piloted with four contacts, three of whom held senior leadership positions within their ICB (one director for primary care, two chief people officers), and one of whom was a practice manager and partner of a GP surgery.

The FOI consisted of five sections. The first two asked about demographic information, including ICB location and responder identity. The third asked about ICB’s general practice wellbeing strategy and services available to staff in general practices within their ICS. The fourth asked whether ICBs collect data on general practices’ staff wellbeing and consult on their needs. The final section allowed ICBs to add anything further to their answers that they considered relevant.

Responses to FOI requests were recorded on an Excel spreadsheet. We used publicly available data to further characterise the ICBs, for example, NHS England data from March 2025 to estimate the number of patients served.24 Responses to open-ended questions — which included PDFs, links to websites, and written prose regarding interventions — were coded thematically.25 Responses related to wellbeing strategy and the list of wellbeing services available to staff in general practice were analysed thematically as described under ‘Characterisation of workplace wellbeing services’ below.

Review of existing information sources

The identification of additional sources of support — informed by our advisory group — included the following: targeted web searching of professional bodies, charities, and other relevant organisations (for example, British Medical Association, the Royal College of General Practitioners [RCGP] Faculties, the Royal College of Nursing, the NHS Practitioner Health, and the Institute of General Practice Management); targeted searching via Google using the keywords ‘primary care’, ‘general practice staff’, and ‘staff wellbeing’; and prior knowledge of the research team (for example, the Care Under Pressure research programme website https://sites.exeter.ac.uk/careunderpressure/external-resources/ hosts a publicly available live archive of resources related to healthcare practitioners’ wellbeing). Information on all sources of support and initiatives identified were recorded systematically on an Excel spreadsheet. Details of all sources of support and initiatives identified using this method were recorded systematically, including the name of the scheme, the organisation involved, whether the scheme is national or regional (and region covered if applicable), and the staff group targeted.

Characterisation of workplace wellbeing services

Based on previous work,19,26–28 our analytical approach to map wellbeing services identified through the FOI responses and our review of existing information sources was informed by a broad understanding of:

  1. ‘workplace wellbeing’ encompassing the promotion of psychological wellbeing (while recognising that psychological and physical health are closely interrelated) and good work experiences across the entire workforce, to supporting those with specific mental health problems;29

  2. ‘interventions’, ‘initiatives’, ‘services’, and ‘strategies’ (and related terms) to refer to a range of potential wellbeing support, including: those aimed at improving the workplace, including the physical environment and workplace provision (break rooms, catering facilities, IT), the organisation of work (for example, shift patterns), the social connection of teams, and workplace culture; those improving personal resources, such as psychological and physical health knowledge, skills, and attitudes (for example, stress management training, mindfulness, skills training, physical health improvement); and those addressing problems after they have arisen (for example, counselling, physiotherapy, debt advice, domestic abuse helplines).19

Services were categorised as national, regional, local, and as targeting general practice staff only, or also other groups.

Results

ICB Freedom of Information request

All 42 ICBs responded by 21 March 2025 (Table 2), but two ICBs stated they did not hold the information (ICB3 and ICB42), with one redirecting us to individual general practices (ICB42). The mean (standard deviation) patient population served by all ICBs was 1 518 046 (718 947.6996). There was considerable variety in responses across all questions, even in terms of roles and grades of responders (Table 2). There were also varying levels of detail in the responses with some ICBs providing resources and documents and elaborated answers to open-ended questions, and others providing minimal information.

View this table:
Table 2. General information about ICBs and their responders

Responders

Sixteen ICB responders indicated they held a primary care specific role (for example, head of primary care), just over one-quarter (n = 11) a non-primary care specific and mostly human resources (HR)-facing role (for example, chief people officers, associate director of human resources), and 15 did not respond to this question.

Responsibility for the wellbeing of general practice staff

Responders in nearly two-thirds of ICBs (n = 27) identified that responsibility for the wellbeing of general practice staff rested with named individual(s) or team(s) within their ICB; nine ICBs identified responsibility rested with individual GP practices and not the ICB; four ICBs did not identify responsibility as resting within the ICB or with individual practices (for example, responded as having no one in this role); and two did not respond.

Wellbeing strategies and plans

Thirteen out of the 42 ICBs reported having a wellbeing strategy specific to general practice staff. Example strategy documents provided by some (for example, ICB6, ICB19, ICB31) outlined interventions combining a focus on: workplace improvements, including more sustainable primary care buildings, flexible working patterns, training hubs with a focus on attracting and retaining specific general practice staff groups (for example, ARRS roles), social hubs or shared interest social groups, coaching and mentoring; increasing personal resources such as via communication skills, stress management, resilience, mindfulness training; and addressing problems after they have arisen, through psychological support, occupational health, addiction support, weight management, personalised wellbeing apps, and so on.

Eleven ICBs reported having a wellbeing strategy for all staff working in the health system (but not specifically general practice staff). Examples varied, ranging from documents such as the above outlining complex workplace strategies developed for a specific subgroup of the ICS workforce, addressing physical, psychological, and social and cultural aspects of staff wellbeing including training (for example, ICB9), to a link to the national NHS health and wellbeing framework (for example, ICB29).

Three ICBs responded that their strategy was a work in progress, of which two (ICB13, ICB24) stated they were developing primary care workforce-specific strategies, and one (ICB15), a general ICB workforce strategy was being ‘drafted in consultation with system partners including the general practice community’.

Eight ICBs responded that they had no strategy or strategy document specific to general practice staff, with six stating that this was owing to responsibility sitting with employing general practices (for example, ICB17, ICB41).

Seven ICBs did not answer the question on whether they had a wellbeing strategy.

Nearly two-thirds of ICBs (n = 27) responded that the wellbeing of general practice staff was part of their business plan, for example, that it was an important element of the ICBs’ primary care transformation or operational plan (for example, ICB19, ICB14). Three stated that incorporating this into the business plan was a work in progress, and one that this was an aspiration.

Five ICBs responded that wellbeing of GP staff was not part of their business plan; two responded that wellbeing of general practice is the responsibility of individual employers; and four provided no answer. Some ICBs provided additional information on their approach and commitment to the wellbeing of general practice staff (see Supplementary Table 1).

Wellbeing services

Thirty-five ICBs provided information (via website links or lists) of wellbeing services available to their staff in general practices, four did not provide any information apart from responding that responsibility sat with individual practices, and three did not answer.

The information shared by the 35 ICBs comprised 139 wellbeing services, of which 21 were listed as national (two labelled as being available to primary care staff only); four as regional (two labelled as being available to primary care staff only); and 114 as local (75 labelled as being available to primary care staff only).

Overall, 79/139 of the services listed were reported as being primary care staff-specific, with 9 of these targeting GPs only but most (n = 70) targeting primary care staff more broadly. The remaining 60 services were available to all healthcare staff, nine to broader health and social care staff, and four also to the general public.

The providers varied and included acute trusts, Local Medical Committees, providers external to the NHS (for example, The WorkWell Programme) and charities (including national charities such as Mind), and combinations of these.

The 139 services listed appeared to encompass: improvements in the workplace such as coaching and mentoring; improvements in workforce resources via mindfulness and resilience training, health and wellbeing webinars for practice staff (on topics including menopause, dementia, and neurodiversity), and access to various wellbeing apps; and services that address problems after they have arisen such as employment assistance programmes, financial support, freedom to speak-up guardians, GP retainer schemes, and support for practices that experience serious violent and aggressive incidents. Most services listed appeared to fall under the category of ‘address problems after they have arisen’, followed by ‘improve workforce resources’, with very few examples of ‘workplace improvements’, and the few of these that were listed being personal support via coaching or mentoring programmes. With the possible exception of health and wellbeing champions and steering groups30 (mentioned five times), no other service appeared to address the organisation of work (for example, improving shift patterns, workload), the social connection of teams, or workplace culture. Supplementary Table 2 reports the full list of all services with some original responses minimally edited for clarity.

Metrics

There was also variability in responses concerning whether and how GP staff workplace wellbeing was measured. Nearly half of ICBs (19) reported collecting data on the wellbeing of staff working in general practices in their ICSs via the NHS General Practice Staff Survey and other surveys conducted by the ICBs. Nine collected data only via the General Practice Staff Survey, and eight ICBs reported not collecting any data at all. Five ICBs did not respond to the question on how staff workplace wellbeing was measured. For examples of further information provided see Supplementary Table 3.

Engagement

Eighteen ICBs reported consulting general practice staff on their workplace wellbeing needs via a combination of surveys conducted by the ICB and the NHS General Practice Staff Survey, eight via the NHS General Practice Staff Survey only, and one via an ICB survey scheme only. Two responded that engagement schemes were under development. Seven ICBs responded that they did not consult general practice staff on workplace wellbeing, and six did not answer the question.

Review of information sources

Our review of information sources identified 53 wellbeing services specifically for general practice staff, along with 81 broader initiatives targeting all healthcare staff. Supplementary Table 4 summarises these sources, detailing the supporting organisations, whether it is national or regional, targeted staff groups, and types of wellbeing support offered. We grouped the types of intervention and support under three categories — workplace improvements, improve workforce resources, and address problems after they have arisen — based on what appeared to be their main focus (Table 3).

View this table:
Table 3. Overview of types of interventions identified via review of existing sources

Over half (n = 31) of the 53 general practice-specific support services were categorised as ‘mental health and wellbeing’ and appeared to mostly target individual problems after they had arisen or improvements in individual and team resources. Of the remaining 22 services, 14 fell under ‘mentoring and community building’, and the rest included ‘advice and support’ and ‘development and training’. There were fewer ‘workplace culture improvement’ services and very few equality, diversity, and inclusion services (that is, LGBTQ+ inclusion, equality or support for international staff, gender equality, religious and spiritual support) that were specific to general practice staff. ‘Mental health and wellbeing’ was also the most common type (n = 30) among the 81 services identified for healthcare staff generally. Other more common areas of wellbeing support for healthcare staff generally included workplace culture improvement (n = 11), equality and support for international staff (n = 8), mentoring and community building (n = 7), financial (n = 6), legal (n = 6), or religious and spiritual (n = 5) support, and gender equality (n = 3).

Discussion

Summary

Responses to our FOI and our review of existing information sources suggest that wellbeing services are available for general practice staff. However, most services are reactive (address problems after they have arisen) and target the individual level. The examples we found of services linked to workplace improvements, that is, mentoring and coaching, were also largely individually focused. We identified very few examples of preventive workplace improvements that were structural, for example, that improved: the organisation of work (for example, shift patterns, rota and leave arrangements, protected breaks); the physical environment and workplace provision (for example, break rooms, catering facilities, parking, IT systems); or workplace culture around wellbeing. FOI responses suggest limited engagement with general practice staff to assess their needs and measure their wellbeing, which are two key features of system level and preventive approaches to workplace wellbeing.31,32 Moreover, FOI responses suggest variation in perceptions of responsibility among ICBs for general practice staff wellbeing and approaches to and provision of wellbeing support, which are crucial in terms of how general practice workforce wellbeing is regarded, prioritised, and pigeonholed. This suggests that workplace support may vary considerably according to geographical location.

Strengths and limitations

To our knowledge, this is the first study mapping workplace wellbeing services for the general practice workforce across England. We adopted an evidence-based system approach to conceptualise workplace wellbeing and an inclusive focus on general practice staff. Our combination of FOI, targeted searches, and stakeholder engagement contributed to the high response rate and our rich dataset.

Our mapping of workplace wellbeing provision is descriptive, and reliant on FOI responses and online information. This precludes our ability to comment on important information about the services themselves; for example, in terms of availability, accessibility, and adoption.33 In order to preserve FOI responder anonymity, we were unable to give greater geographical details. Services such as the NHS Practitioner Health Programme are mentioned in both Supplementary Table S2 and S4 but it is difficult to assess further overlap systematically. Where ICBs did not consider general practice staff wellbeing as within their remit of responsibility, we were unable within the scope of the current study to explore whether strategies and services in those areas were in place at local primary care network or individual GP practice level. Despite several attempts via research team and advisory group links, and combinations of blanket and targeted recruitment strategies, our advisory group had limited diversity in terms of ethnic backgrounds and professions (for example, it lacked allied health professionals [AHP] and ARRS roles). These challenges in engaging these groups may reflect their work-related pressures and challenges.

Comparison with existing literature

Our finding of a lack of structural preventive approaches corroborates existing research on support for healthcare professional workplace wellbeing,34 including a recent systematic review of wellbeing interventions in family medicine and general practice trainees,35 reporting that most interventions have a focus on reducing ill-being (rather than promoting wellbeing) and a tendency to target the individual level. This is also in line with research on doctors from secondary care settings28 showing how wellbeing solutions tend to target the individual level and be misaligned with structural issues that are reported as reducing workplace wellbeing. Although there are some examples of good practice (for example, ICBs with comprehensive strategies and services supporting general practice staff wellbeing), we have potential concerns over the sustainability and prioritisation of strategies and approaches to support general practice staff in light of the forthcoming challenges that ICSs and ICBs will face.

Implications for research and practice

Research highlights the need for interventions and policies aimed at addressing burnout and improving job satisfaction to retain GPs7 and primary care staff.36,37

We found a considerable number of interventions, but most of these do not address structural issues, which are key causative factors of poor workplace wellbeing.34,38,39 This is in line with research suggesting that evaluating and improving existing interventions is likely to be more effective than developing new ones.31

Future research can build on our mapping to further explore, evaluate, and improve how the health and wellbeing of the general practice workforce is supported, drawing on wider research evidence and learning from areas of good practice. Engaging with relevant stakeholders — including general practice and primary care staff, and patients — will be key to evaluate and optimise the impacts of workplace wellbeing support.40–42

Notes

Funding

This project was funded by NIHR School for Primary Care Research; Project No: 702; Funding round: FR 9. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Ethical approval

As this study used the FOI process and analysis of publicly available material no ethical approval was required.

Provenance

Freely submitted; externally peer reviewed.

Acknowledgements

We would like to thank the responders to our FOI requests and members of our Advisory Group.

Competing interests

AA provides coaching and professional support for primary care staff (mostly doctors and practice managers) as part of the Devon Local Medical Committee support services. GW works part time as GP for the NHS.

  • Received August 8, 2025.
  • Revision received November 10, 2025.
  • Accepted December 18, 2025.

This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

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Workplace wellbeing for the general practice workforce across England: mapping current services
Lorna Hardy, Daniele Carrieri, Alex Aylward, Karen Mattick, Geoff Wong, Jane R Smith
BJGP Open 25 August 2026; BJGPO.2025.0169. DOI: 10.3399/BJGPO.2025.0169
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British Journal of General Practice