In charts: How GPs fell out of love with partnerships

A few decades ago, many practices could expect to be deluged with responses to ads for a partnership vacancy. The charts below show how the profession is increasingly turning its back on the role.

In 1990, BMA chair Dr Chaand Nagpaul had to fend off competition from 80 other applicants to secure a partnership at the London practice where he remains a senior partner. This experience is one shared by many GPs of his generation.

Fast forward nearly 30 years to 2018, and many practices are lucky to have a single applicant for partnership roles. Just last year, GPonline reported that one in four partners said their practice had an unfilled vacancy for a GP partner.

Over the past two years, the decline in GPs choosing partnership roles has been marked, as the figures below reveal.

Plummeting numbers of GP partners have finally raised eyebrows in Westminster - with health secretary Jeremy Hunt last week appointing a senior GP to lead a review that aims to 'reinvigorate' the partnership model of general practice.

But the review will do well to create a major swing in GPs' interest in partnerships, given that just a fifth of GPs say being a partner is currently their first choice.

Among the chief drivers of this decline in partners is the contrast between rising workload and falling pay. Real-terms income for partners fell around 25% between 2004/5 - when the new GMS contract took effect - and 2015/16. This suggests that for the partnership review to have any real impact it will need to be backed by major new investment over and above the GP Forward View - which the BMA has said will leave general practice £3.4bn short of the share of NHS funding it needs by the end of the decade.

Rising numbers of patients - the total population registered with GP practices rose 1.4m between October 2015 and October 2017 - have left practices struggling with rising workload. Findings from our recent opinion polls suggest that many partners are working extremely long hours to keep their practices going.

As a consequence, practices' reliance on locums is growing, with around one in six GP sessions now filled by locums, according to our recent polls.

As GPC sessional subcommittee chair Dr Zoe Norris has said, this locum workforce is a vital resource without which general practice would not be able to keep going. However, on current trends the partnership model is heading for extinction, because many doctors see switching to locum or salaried roles as the only way to manage workload and maintain income.

GPC chair Dr Richard Vautrey told GPonline last year: 'This is a really serious problem because the fundamental way that NHS general practice operates is through the contractor model. We risk the demise of that at our peril – the whole of the NHS depends on the risk management by practices in their day-to-day work and we know how valued it is among patients.'

Photo: iStock/frender

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