Falling GP income and workforce highlighted in government pay evidence

Falling GP numbers, a huge real-terms decline in income for the profession over the past decade and a sharp drop in the number of sessions GPs work are highlighted in government evidence to the body that advises ministers on doctors' pay.

DHSC evidence on pay acknowledges concerns for general practice
DHSC evidence on pay acknowledges concerns for general practice

Evidence to the Doctors and Dentists Review Body (DDRB) - the independent body that advises the government on pay for medical professionals - from Jeremy Hunt's newly renamed department of health and social care (DHSC) highlights many of the key factors behind the crisis facing general practice.

It acknowledges falling numbers of GPs, the sharp decline in average GP income over the past decade, a steady fall in numbers of sessions GPs tend to work, and a shift away from partnerships to locum and salaried roles.

Figures submitted by the DHSC also show that the number of GPs taking early retirement has doubled in recent years, although many of these may remain within the active workforce.

Average sessions GPs work is in decline

Credit: DHSC evidence to DDRB

The DHSC evidence warns: 'Many practices continue to face recruitment issues, and newly qualified GPs are often working as locums rather than joining a practice as a permanent GP.

'Some older GPs are also leaving the profession early. This is leaving a gap between the number of doctors practices want, and the numbers they are successfully recruiting and retaining.'

The evidence points to plans to boost international recruitment, retention schemes, the expansion of GP training posts, GP Forward View funding, new care models and plans for a state-backed GP indemnity deal announced last year by the health secretary as part of its strategy to turn the situation around.

GP funding

But the BMA has warned repeatedly that general practice in England will remain underfunded by £3.4bn by 2020/21 even if GP Forward View investment is delivered in full - and increases in GP funding in recent years have barely kept ahead of inflation.

The DH evidence shows that average income for GMS and PMS partners in England fell in cash terms from a high of £113,614 in 2005/6 after the QOF was introduced, to £104,900 in 2015/16. In real terms - taking into account inflation - partners' income fell 23% over this 10-year period from the equivalent of £136,665 to £104,900.

Evidence submitted by the DH also shows the extent to which soaring pressure on general practice has driven GPs into cutting back on the number of sessions they work. In 2010 less than a third of GPs worked six sessions or fewer per week, whereas by 2015 this figure had risen to 41%, while the proportion working more than 9 sessions per week fell from 35% to just 22%.

GPonline reported last year that the full-time equivalent GP workforce fell by almost 1,300 from 34,592 to 33,302 in the two years to September 2017 - leaving the government more than 6,000 GPs short of the 39,500 target it is aiming to deliver by September 2020.

The BMA said it would submit its own evidence to the DDRB once evidence had been submitted by all four UK governments.

The government has suggested it will take a 'more flexible approach' to public sector pay for 2018/19 after several years of restraint. Negotiations between the BMA and the DHSC over the GP contract for next year are continuing.

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