Ruth Abrams is an organisational psychologist and health services researcher at the University of Surrey with an interest in the Primary Care/NHS workforce, and is a member of the BJGP Editorial Board. She is on LinkedIn
Victoria Williams is a women‘s health researcher at the University of Surrey with an interest in workplace wellbeing. She is on LinkedIn
This time last year, we eagerly awaited the release of the ten-year NHS workforce plan. Twelve months on and we’re still waiting.
Women now make up over half of the GP workforce. Evidence shows worrying findings of higher rates of burnout, emotional exhaustion, and intentions to leave.1,2 We also know that women GPs are more likely to face challenges in career progression.3 Investigation shows this is not due to individual capability or commitment, but to structural and cultural conditions within general practice. There are gendered intersections that make working as a woman GP in today’s NHS particularly challenging.
…thriving for women GPs is produced by everyday organisational conditions across three concepts: (i) patient-facing work, (ii) navigating competing demands, and (iii) sustainable careers, leadership and success.
Women GPs have been shown to undertake longer, more complex consultations including women’s and children’s health and mental health appointments.4 They also carry disproportionate emotional labour at both work and home.5 Yet systems prioritise speed, availability and linear careers, making flexible working and caring responses less viable. This mismatch between what is valued and what delivers safe, high-quality care undermines wellbeing, equity and retention, and means women GPs are less likely to thrive at work.
In 2024, funded by the National Institute for Health Research, we undertook a realist review to explore existing evidence, identifying the conditions in which women GPs can thrive in general practice. Our role was to collate the evidence on women GPs and thriving in general practice, as well as to identify any interventions implemented in the workforce which may supports this. We reviewed over 1,000 documents, 72 of which were analysed in depth to answer how, why, for whom and in what circumstances women GPs can find a positive working environment.
Findings show that thriving for women GPs is produced by everyday organisational conditions across three concepts: (i) patient-facing work, (ii) navigating competing demands, and (iii) sustainable careers, leadership and success.
Patient facing work
Women GPs deliver deeply patient-centred care – they listen closely, explore psychosocial questions, explain treatment options and support holistic decisions. This has multiple benefits like stimulating greater patient disclosure, whilst limiting unnecessary prescriptions. But this strength also attracts additional demands seen across complex cases (like individuals with multiple conditions), heavier emotional labour and longer hours spent in consultation. These are both unrecognised and unrewarded in the system. When this is coupled with gendered expectations and higher rates of mistreatment (ranging from general sexist remarks, doubting clinical ability, to sexual harassment and discrimination from both colleagues and patients), the risk of burnout and leaving the profession rises. However, when a patient centred approach is upheld by all GPs, it supports women GPs to thrive, feel safe and sustain the care that they value and find meaningful, because it shifts the unequal distribution of this additional layer of work.
Navigating competing demands
…mismatch between what is valued and what delivers safe, high-quality care undermines wellbeing, equity and retention, and means women GPs are less likely to thrive at work.
Women GPs can rely on strong social support networks to help juggle clinical work with caring responsibilities. Yet they continue to face intense pressures to excel in every role. This strain can be amplified for early-career GPs with young children, and those from minority backgrounds, where cultural expectations heighten the load. When workplaces expect overtime or inflexible schedules, women GPs have less capacity for leadership, training or practice ownership, slowing career progression and increasing dissatisfaction and burnout. However, many turn to flexible and portfolio roles or part-time work to regain flexibility and control over their schedules. Whilst this can work for some, part-time hours remain undervalued for both male and female GPs, leading to reduced respect and higher turnover. Creating environments that genuinely support flexibility and recognise all work patterns is essential for women GPs to thrive by supporting autonomy, energy and sustainability in the profession, but more so policies which are effective for all staff, including male carers, will benefit the entire workforce and patient care.
Sustainable leadership, careers and success
Women GPs thrive when they have access to career-enriching support that evolves with their life and career stages. Supervision groups, positive mentors and healthy practice dynamics create safety, belonging and the confidence to manage complex patient care. Not all women define success the same way – many value mentoring, community and job crafting over traditional leadership routes. Supporting these varied pathways boosts wellbeing and career longevity. Experienced women GPs often report greater fulfilment because they’ve developed strategies to navigate gender-specific challenges. Emerging initiatives including coaching programmes to women-centred professional networks, show promise in building community, improving wellbeing and opening doors to mentorship and development, especially when offered early in a GP’s career.
Implementation and evaluation of initiatives to support women GPs can shift the dial from survival to sustained thriving for women GPs, and potentially for all staff. Long term, this may have a positive spill-over effect for patient care, system resilience and equity. Our evidence-based findings have enabled us to develop a discussion guide for practices, designed to facilitate open, respectful conversations among practice staff about workplace culture, equity and support for women GPs to thrive in general practice. Action now needs to happen at an ICB and practice management level, to better support women GPs who are currently fixing things at an individual level.
Access our guide to informing culture change here: https://www.workplacethriving.co.uk/conditions-where-women-gps-thrive and read the full paper ‘Investigating the conditions in which women GPs thrive in General Practice: A realist review’ in the British Journal of General Practice here: https://doi.org/10.3399/BJGP.2025.0785
This project is funded by NIHR HSDR, Award number: 161818. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
References
- Shiner A, Watson J, Doohan N, Howe A. Learning or leaving? An international qualitative study of factors affecting the resilience of female family doctors. BJGP Open. 2020 4 (1): bjgpopen20X101017. DOI: 10.3399/bjgpopen20X101017
- Bardoel EA, Russell G, Advocat J, Mayson S, Kay M. Turnover among Australian general practitioners: a longitudinal gender analysis. Hum Resour Health. 2020 Dec 9;18(1):99.
- Jefferson L, Webster E, Golder S, et al. Barriers to and facilitators of women GPs’ careers: a systematic review. BJGP Open. 2025 Oct 1;9(3). https://bjgpopen.org/content/9/3/BJGPO.2024.0282
- Mayson S, Bardoel A. Sustaining a career in general practice: Embodied work, inequality regimes, and turnover intentions of women working in general practice. Gender, Work & Organization. 2021;28(3):1133–51.
- Abrams R, Williams V, Park S, Jefferson L. Easing parenting challenges in primary care workforce BMJ 2026; 392 :s553 doi: https://doi.org/10.1136/bmj.s553
Featured photo by Cherry Laithang on Unsplash
