General practice is 'chronically overstretched and haemorrhaging doctors'

GP leaders have raised the alarm over unsustainable workload in general practice as the profession continues to haemorrhage doctors - warning that the situation is 'likely to get worse'.

GP consultation
(Photo: sturti/Getty Images)

General practice has lost 442 full-time equivalent (FTE) fully-qualified GPs in the past year alone and more than 1,500 over the past five years, the latest data from NHS Digital show.

Numbers of patients registered with GPs have risen close to 62m, leaving each FTE GP responsible for more than 2,200 patients - a figure 16% higher than when records began in 2015.

GP leaders warned that current levels of workload were unsustainable and unsafe, and hit out at 'constant undermining and devaluing of general practice by government and policymakers' - including through unfunded, below-inflation pay awards announced on 19 July.

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Patients per GP up 3% in a year as workforce slumps by over 440

RCGP chair Professor Martin Marshall said: 'Despite repeated promises to boost GP numbers, today’s figures show that we have more than 1,500 fewer qualified, full-time equivalent GPs than we did five years ago. The result is a chronically over-stretched and under-resourced general practice service, with GPs and their teams working to their absolute limits to deliver increasingly complex care to the ever-rising number of patients that need it.'

BMA GP committee workforce policy lead Dr Samira Anane said: 'With no action to address the shortfall and continuous exodus of GPs, more practices will close and patients will lose access to their family doctor, with huge consequences for their health and an already-collapsing NHS.'

GPonline reported earlier this year that more than 1,600 GP practices have merged or closed since NHS England became operational nearly a decade ago, sending the number of GP practices in England down by a fifth while average practice list size grew 37%.

GP practices delivered an unprecedented 367m appointments in 2021, and appointments in the first six months of 2022 - excluding COVID-19 vaccinations - have outstripped the same period last year by 8%.

GP workload

Dr Anane said rising patient numbers and a GP workforce in decline meant that patients already facing 'the biggest hospital waiting lists for treatment ever' would continue to struggle to get the care they need.

She said: 'In the past year alone, the NHS in England has lost the equivalent of 442 full-time, fully-qualified GPs, with almost 70 of these being in the most recent month. This is the equivalent of more than 150,000 people losing ‘their family doctor’ in one month.

'GP partners, who run practices, are leaving at a greater rate due to the intense pressures of their roles. While many are managing their workload and protecting their own wellbeing by limiting the hours they are working, others are leaving entirely - shown by the drop of more than 850 GPs by headcount. As more GPs leave, their colleagues take on far more, with the situation on the ground a world away from the "part-time" GP narrative we see peddled so often.'

Professor Marshall added that general practice was 'continuing to deliver more consultations every month than pre-pandemic, with more than 26m appointments delivered in June, and over 44% of those on the same day they were booked.

He said: 'Working at this intensity is unsustainable and it’s unsafe for both patients and staff. An exhausted GP is not able to practise safely or deliver the high-quality care and services they are trained and want to deliver for patients.

'This is leading to GPs and other members of our teams burning out and having to evaluate their futures working in general practice, in some cases leaving the profession earlier than planned and in others reducing contracted working hours to make the job more sustainable. Yet working 'part time' in general practice often means working what would normally be considered full-time, or longer - and will likely include many hours of paperwork on top of patient appointments.

'The sad reality is that this situation is likely to get worse.'

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