Falling GP income driving recruitment and retention problems, study warns

A sharp fall in real-terms income for partners and salaried GPs over the past decade may be a key factor fuelling problems with recruitment and retention in general practice, a study has found.

GP income warning (Photo: jax10289/Getty Images)
GP income warning (Photo: jax10289/Getty Images)

Real-terms income for GP partners fell by 10% between 2008 and 2017 after adjusting for sessions worked, a study published in the British Journal of General Practice (BJGP) shows - while salaried GPs saw a 7% drop.

Average standardised income adjusted for inflation for GP partners fell from £109,363 in 2008 to £98,373 in 2017, the University of Manchester study found.

Among salaried GPs - whose average pay is significantly lower in part because this group are less likely to work full time than partners - average inflation-adjusted standardised income fell from £55,080 in 2008 to just £51,208 in 2017.

GP income

The researchers pointed out that in December 2017, the average annual income for an NHS consultant was £112,040 - 'significantly higher than the mean income this study found for partner GPs, and over twice that of the mean income it found for salaried GPs'.

GPonline has reported heavily on the major decline in partners' income in the decade following the introduction of the new GMS contract in 2004. The 2004 contract, which followed years of stagnation in GP pay, brought a sharp rise in GP income over the following two years - in particular as practices began to earn new funding through the QOF.

But much of the gain from the 2004 deal has since been wiped out - as the BJGP study's findings confirm - through years of public sector pay freezes.

The study's authors say that comparison of 2017 consultant incomes with data from 2012 show that - despite a decline for GPs - 'it is clear that this downward trend in income is not present for consultants'.

Career choice

They warned: 'This suggests that there is a greater financial incentive for medical students to train as consultants, as opposed to GPs. This is reflected in a 2018 survey of doctors in training, with a significantly larger proportion of responders reporting consultant as their ultimate career goal compared with GP.'

They added: 'GP income has fallen in real terms between 2008 and 2017 for both partner and salaried GPs. The decrease in GP income adjusted for sessions worked and inflation over the last decade may have contributed to the current problems with recruitment and retention.'

Findings from the BJGP study reveal that data published annually by NHS Digital on GP earnings and expenses overstate the decline in GP income over the past decade because they do not adjust for changes in the proportion of the workforce working part time over the period.

The study found that the proportion of both partners and salaried GPs working part time had increased over the 10-year period, with partners working 7.7 sessions per week on average in 2008 compared with 7 sessions in 2017.

Among salaried GPs, average sessions worked per week fell from 5.6 in 2008 to 5.3 in 2017.

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