UK Doctors' Salary and Satisfaction Report 2021
With COVID-related NHS pay a hot topic, how have UK doctors' salaries changed, and is the gender pay gap narrowing? We also explore work challenges in our third UK-specific Medscape doctors' income survey, which is based on responses from more than 1000 GPs and specialists who are Medscape members, between 10 November 2020 and 16 February 2021.
Label values on charts are rounded but rankings and calculations are based on raw data to avoid rounding errors
UK Doctors' Salary and Satisfaction Report 2021
Overall, UK doctors' average earnings dropped by £10,000 to £103,000 last year. GPs saw the biggest drop of £12,000 to £92,000, while specialists saw pay drop by £9000 to £105,000. Female doctors' pay fell by more than their male counterparts (£9000 vs £6000) and over-45s had a bigger fall than under-45s (£13,000 vs £4000). In 2018, 17% of doctors said their income had dropped. This time the figure was 29%.
UK Doctors' Salary and Satisfaction Report 2021
Most doctors in our survey only work in the NHS (73%), so enforced pay cuts are unlikely to be to blame, although contracts may have changed income for some GPs.
Only 4% work only in private practice and 23% do a mixture of NHS and private practice. Delays in referrals under COVID-19 and restrictions on private practice with infection control measures could have reduced these earnings.
Among the NHS workers, 19% were junior doctors with lower salaries overall. There were slightly more female participants this year (31% compared to 27% in 2018) so the gender pay gap could affect the data.
Other Medscape UK surveys have suggested many doctors were considering changing jobs or type of practice due to burnout, which could have affected income.
Average hours worked each week remained at 47, the same as 2018. Male doctors worked slightly more hours (47.55) than females (45.82).
Only 6% of doctors were financially rewarded for meeting specific goals or targets, such as diagnoses, waiting list reduction or prescribing. Incentives were far more common for GPs (18%) than specialists (4%).
Malpractice insurance payments have increased for 37% of survey respondents.
UK Doctors' Salary and Satisfaction Report 2021
Among the 34% reporting a rise in earnings, career progression, a national pay rise, and increments were common reasons given. One said: "General shut down of NHS due to COVID has enhanced private practice." For another it included "extra shifts for COVID", and for another, simple "hard work".
Among the 29% reporting a decrease in earnings, some reasons given were:
- Have been working fewer hours over COVID due to burnout
- Working 80% for a few months as could not continue full-time due to overworking, stress
- COVID-19 wiped out private practice
- No access to hospital theatres from COVID
- Loss of waiting list initiatives
- Lockdown, inability to do non-essential profitable work
- Predatory behaviour of malpractice insurers
- Paying for parking and less work
- Rising cost of living and frankly shoddy treatment of the entire medical profession by the Government
- Increased tax and contributions
- Prolonged periods of absence due to sick days and self-isolation
UK Doctors' Salary and Satisfaction Report 2021
This year's overall doctors' gender pay gap was £35,000, meaning female pay was 30% lower than male pay. That's up from £32,000 in 2018.
The gap was £34,000 between male and female specialists, with men earning 41% more than women.
England's Health Secretary Matt Hancock first promised action on gender equality in 2019.
UK Doctors' Salary and Satisfaction Report 2021
The majority of doctors in our survey (61%) don't feel they are fairly rewarded for their work. More GPs (66%) felt under-rewarded than specialists (61%).
The gender pay gap probably had an influence on more female doctors (67%) than males (59%) feeling under-rewarded.
Across the generations, pay dissatisfaction was highest in Millennials (74%) then Generation X (63%), and Baby Boomers (50%).
UK Doctors' Salary and Satisfaction Report 2021
Despite the disappointment with pay, only 9% of doctors feel they are living above their means. For the rest, 66% live at their means, and 26% below.
When it came to paying off debts, loans or expenses, main home mortgages were the biggest drain on finances, followed by car loan or lease payments, and children's private school or university fees.
UK Doctors' Salary and Satisfaction Report 2021
Taking stock of finances overall, doctors average net worth was £492,000.
Specialists were better off than GPs (£502,000 vs £417,000), and males were nearly twice as well off as females (£596,000 vs £310,000).
Across the generations, net worth rose with age and career progression:
- Millennials £127,000
- Generation X £430,000
- Baby Boomers £836,000
For the 83% who own their own home, average equity was £333,000. Twenty-three percent of homeowners have no mortgage or have paid it off.
UK Doctors' Salary and Satisfaction Report 2021
All things considered, were our survey participants still happy to have become a doctor? Yes, said 80%, no said 20%.
This positive feeling increased over the generations:
- Millennials 68%
- Generation X 79%
- Baby Boomers 88%
Sixty percent would still pick medicine as a career if they had to start over again.
Again, this feeling rose over the generations:
- Millennials 48%
- Generation X 59%
- Baby Boomers 69%
Eighty percent would pick the same specialty, and 19% the same practice setting. However, among doctors with children, only 33% would recommend medicine as a career for their children.
UK Doctors' Salary and Satisfaction Report 2021
Among those still happy to have become a doctor, common reasons given included:
- Pride in treating fellow humans
- I love making a difference
- Good, noble profession
- Marvellous to be able to help people
- It is an intellectually and emotionally satisfying job
- It's still the best and the worst job in the world
UK Doctors' Salary and Satisfaction Report 2021
We asked about the most rewarding aspect of the job.
Being very good at what they do, finding answers and diagnoses, was the most common answer, followed by making the world a better place/helping others, and gratitude/patient relationships.
Despite concerns raised about pay in earlier answers, 'making good money at a job that I like' was the most rewarding aspect for 8%.
Pride in being a doctor was more common among males (9%) than females (5%).
Pride also took a mid-career dip:
- Millennials 9%
- Generation X 5%
- Baby Boomers 10%
UK Doctors' Salary and Satisfaction Report 2021
NHS staffing levels, rules and regulations, and difficult patients were the most common work challenges.
GPs were more likely to cite difficult patients (17%) than specialists (10%).
GPs were also more concerned about being sued (12%) than specialists (6%).
NHS rules and regulations were more of an issue for males (29%) than females (15%).
These 'red tape' frustrations also increased across the generations:
- Millennials 13%
- Generation X 24%
- Baby Boomers 32%
UK Doctors' Salary and Satisfaction Report 2021
Among those who see patients, the average number seen in a week was 50. GPs saw an average of 87 patients a week compared with 44 for specialists.
The average number of hours a week seeing patients was 31.2 overall.
The most common consultation length was 9-12 minutes.
Doctors spent an average of 16.3 hours a week on admin, paperwork, and other medical duties outside of consultations.
UK Doctors' Salary and Satisfaction Report 2021
The majority of doctors (83%) were satisfied, or very satisfied, with their own job performance.
More GPs (11%) were dissatisfied/very dissatisfied than specialists (5%), more females (8%) were dissatisfied/very dissatisfied than males (5%).
More over-45s (86%) were satisfied/very satisfied than under-45s (77%).
We also asked, in your current practice setting, is it your aim to get promoted or move up the ranks? Yes, said 46%, no said 54%. Females were more likely to say yes (53%) than males (42%).
This ambition decreased across the generations:
- Millennials 79%
- Generation X 45%
- Baby Boomers 22%
UK Doctors' Salary and Satisfaction Report 2021
Over the past year, with the background of COVID-19, 83% of doctors told us working in the NHS has become harder. There was no change for 14%, and it was easier for 3%.
We asked about the biggest frustrations of working in the NHS. Common themes amongst the responses included:
- Bureaucracy, poor staffing levels, lack of admin staff
- Ever increasing workload for decreasing pay
- Low staffing levels on the ground, too many managers and red tape
- Being politicised and reorganised
- Poor IT clumsily implemented and poorly supported
- Bullying
- Ungrateful patients and unnecessary complaints
- Tick box exercises
- Burnout of overstretched frontline staff with the loss of quality performance, rendering the whole system somewhat unfit for purpose
- Constantly being told to work harder, faster, longer with no recognition that we are not machines
- Spineless and brainless managers
- The ridiculous huge taxations on pensions … has hit me hard
- Clapping being considered a fair payment for working in a pandemic
UK Doctors' Salary and Satisfaction Report 2021
Having identified key frustrations about working in the NHS, what would improve matters? Common themes amongst the responses included:
- Truly clinically led organisation of the health service
- Reimburse GP practices adequately
- Ease off the grip of management on clinicians
- Reduce the defensive paperwork
- Better training for all staff re diversity
- Stop bullying SAS doctors with passive/aggressive BAME discriminatory techniques
- Stop bullying and harassment
- Provide better PPE
- Improve IT
- Cut the red tape! Just let me do my work!
- Being told that you are doing a good job
- Reduce paperwork
- Improve staffing levels
- Stop clapping, pay us
UK Doctors' Salary and Satisfaction Report 2021
Among those who were satisfied or very satisfied to be working in the NHS, some common positive reasons given included:
- Job security and team working
- Being part of a team, delivering results
- Working with colleagues to provide world-class service for our patients
- Gratitude of the patients
- Camaraderie and a general appreciation from society
Public funding was also a key motivation:
- Care delivered by need not ability to pay
- Being able to treat patients without worrying about cost
We asked how often the cost of treatments was discussed with patients, privately or within the NHS. Never, said 61%, occasionally said 30%, and regularly for 9%.
Discussing costs was considered inappropriate for 46%, and 21% didn’t know the cost of treatments.
UK Doctors' Salary and Satisfaction Report 2021
Twenty-nine percent of doctors were considering leaving the UK to practise in another country. That's slightly lower than 2018.
Leaving the UK was more commonly considered this time among under-45s (45%) than over-45s (20%).
For doctors who moved to the UK to practise medicine, Brexit affected plans for 22%.
We also asked about whether doctors were planning to do more private work. Twenty-seven percent were, that's slightly lower than 2018 (28%).
UK Doctors' Salary and Satisfaction Report 2021
In our 2018 survey, 26% of doctors had used teleconsultation.
The impact of the pandemic was clear in this year's results with 68% having done remote consultations. This was more common among GPs (90%) than specialists (64%). Overall, 72% were satisfied with their teleconsultation experience, and a further 15% are planning to use teleconsultation.
"Teleconsultation can be an effective way to deliver high-quality care," one doctor told us. "It can be more accessible to patients than clinic-based care and is more efficient and environmentally friendly."
Another said: "The past year has forced us to embrace this finally. Still learning how best to use. NHS WiFi is terrible & IT is ancient."
Another pointed out: "Difficult to make decisions without physical examination. Many consultations take longer than they should. Many patients end up requesting a face-to-face appointment making this a waste of time, effort, and a clinic slot."
Thirty-eight percent of doctors in our survey used or recommended connected gadgets, like activity trackers, sleep trackers, connected scales, or smartwatches.
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