General practice lost one in 30 partners last year, official data show

The number of full-time equivalent (FTE) GP partners in England dropped by 543 in the year to June 2021 - a 3.1% drop - with partners now in the minority in headcount terms in a quarter of CCG areas.

(Photo: Mike Kemp/Getty Images)
(Photo: Mike Kemp/Getty Images)

Figures released last week by NHS Digital show that there were 17,035 FTE GP partners in England in June 2021 - down from 17,578 a year earlier, and down a staggering 2,308 (11.9%) from 19,343 in June 2018.

The true decline may be slightly larger - because the June 2018 are based on returns from 98.7% of GP practices in England at the time, while the latest data are based on returns from 99.6% of practices, after a change in methodology that has angered the BMA.

GP partners still make up 61% of the fully-qualified FTE GP workforce. But in headcount terms just 53% of fully-qualified GPs were in partnership roles in June 2021, down from more than 58% just two years earlier.

GP partners

In a quarter of CCG areas in England partners are now in the minority, according to analysis by GPonline that also shows stark gaps in practices' ability to recruit partners between areas.

In Southend CCG in Essex, just 39% of GPs are in partnership roles, the lowest proportion in the country - compared with 75% in Calderdale CCG in West Yorkshire.

Despite the continuing sharp decline in GPs in partnership roles, there may be signs that the fall is slowing. The 3.1% drop in GP partners in the year to June 2021 followed a 4.2% fall over the previous year, and a 5.2% drop in the year before that.

GPs in salaried roles, meanwhile, are rising rapidly - with 9,499 FTE salaried GPs in June 2021 compared with 8,684 a year earlier, a rise of 9.4%. The rise may reflect a shift from partnership roles, but also a move among locums to permanent roles after uncertainty over employment during the pandemic.

Workload

Alongside the decline in GPs in lead roles within practices as partners, general practice continues to face huge workload pressures after more than a year of the COVID-19 pandemic.

GPonline reported last month that appointments in June this year were up 31% compared with June 2019 - before the pandemic began - once appointments for COVID-19 vaccination were taken into account.

In comments collected by the BMA, a GP in the south of England said: 'I’m a partner and in the past year I have lost a partner to early retirement and two partners to periods of sick leave due to the stress of the job.

'You cannot talk about workforce in general practice without also talking about workload. We simply do not have enough GPs to cope with ever-expanding patient demand. Our funding assumes three patient contacts per annum for every patient on our list. We are currently running around seven per annum.

Workforce

'I have asked a couple of our salaried GPs who I think have the right stuff to be partners whether this is something they would consider but their response is always the same - they see how hard we’re working and do not want to subject themselves to the same ever increasing workload.'

Another GP in south-west England said: 'I have just got home from another 13-hour day. There is a vicious cycle happening with our poor workforce numbers nationally. Every time a GP reduces their hours or quits, or a post is unfilled, the strain on the remaining GPs increases. That leads to more GPs leaving. We can't keep doing this. So many of us are at breaking point.'

A GP in the north of England said: 'The government says that there are more staff working in primary care, funded through the additional roles reimbursement scheme - this may be true, but they are not reducing the work on GPs; if anything they are only assisting with otherwise unmet need. The GP partner workforce is decreasing - I know of colleagues and practices where colleagues are either retiring early or leaving for work elsewhere.'

Following a change of methodology that has sparked anger among doctors' leaders, NHS Digital is no longer using estimated data for practices that have not submitted returns to make figures from each time period directly comparable.

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