BMA demands honesty from government and NHS over GP workforce crisis

Doctors have condemned 'misleading' claims from the government and NHS England that downplay the general practice workforce crisis - urging ministers to 'fix the GP shortage, rather than fixing the data'.

Dr Krishna Kasaraneni (Photo: BMA)
Dr Krishna Kasaraneni (Photo: BMA)

Responding to BMA polling that found GPs had overwhelmingly rejected the access plan and support package for general practice published last week, a DHSC spokesperson said: 'The number of full-time equivalent doctors in general practice increased between March 2016 and March 2021.'

A similar line appeared in the access plan itself, which said there were 'now over 1,200 more full-time equivalent (FTE) GPs than two years before' based on figures for June 2019 compared with figures for June 2021.

However, the figures cited by the government and NHS England include trainees - masking the fact that the fully-qualified GP workforce actually fell or grew only slightly in these periods.

GP workforce

NHS Digital figures show that fully-qualified, FTE GPs fell by 986 between March 2016 and March 2021, a 3.4% drop. In the two-year period to June 2021, meanwhile, fully-qualified FTE GPs increased by 101 - less than a tenth of the figure used in the access plan.

The BMA has also hit out at a recent change in methodology that means NHS Digital no longer includes estimated figures for practices that fail to submit data - a move that has made reductions in the GP workforce over the past five or six years look smaller.

Under the old methodology, fully-qualified FTE GPs fell by more than 500 in the two years to June 2021, and are down by around 1,800 since 2015.

BMA GP committee executive team member Dr Krishna Kasaraneni told GPonline: 'The BMA believes that the government’s interpretation of the GP workforce figures is disingenuous and fails to give an honest assessment of the true picture.

GP trainees

'The bottom line is we are haemorrhaging doctors, not significantly gaining them; we have lost the equivalent of 1,803 full-time, fully-qualified GPs since 2015, despite the government promising 6,000 more. This is the statistic ministers should be using.

'While more younger doctors are choosing to enter general practice, even more are leaving the profession. The government should not be including trainees in the figures they use. This is because they are in training and not operating as fully-qualified GPs, and some trainees accounted for among these numbers will not even go on to specialise in general practice at all.

'Even more worrying, we saw NHS Digital change its methodology for the data in the summer, and by no longer including estimates to account for practices who did not submit workforce data previously, it makes the picture look far less concerning than it really is.

'So, while NHS England heralds a rise in 1,200 GPs between June 2019 and June 2021, our analysis shows that there was a loss of the equivalent of 505 full-time GPs in the same period. The government and NHS England needs to focus on fixing the workforce shortage rather than fixing the data.

GP crisis

'This is disingenuous at best and downright misleading at worst. It’s time the government and NHS England are honest about the workforce crisis and crucially support GPs and their teams, to prevent more experienced GPs being forced to reduce their hours or leave the NHS all together - something that was completely absent from the woeful ‘package’ announced last week.'

The DHSC said the government remains committed to increasing GP numbers and suggested the inclusion of GPs in training and specialty registrar trainees on placements in general practice in the overall workforce figure was justified because they are qualified doctors who can provide support to fully-qualified GPs.

The dispute over workforce figures comes as the BMA's GP committee is nearing industrial action after the access plan and support package left the profession 'dismayed'.

RCGP chair Professor Martin Marshall warned last week that despite general practice evolving faster than ever in the face of intense pressure, only a significant rise in GP numbers could solve the problem of unmanageable workload in the profession.

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