Government accused of 'misleading' claims on general practice workforce

GP leaders have accused the government of making misleading claims about the general practice workforce after it said numbers of doctors in general practice were rising and that plans to bring in 26,000 staff to support primary care were 'on track'.

GP consultation
(Photo: SolStock/Getty Images)

A government statement on 19 May said it was 'on track to deliver on [a] manifesto commitment of 26,000 more primary care staff to help improve patient access to appointments and reduce the COVID-19 backlog'.

It said there were 'over 18,200 more people working in general practice in March 2022 compared to March 2019' and 'over 1,400 more doctors'.

However, the figure quoted by the DHSC on numbers of doctors working in general practice includes GP trainees - who are not able to practise independently. Once trainees are stripped out, official data show that the full-time equivalent (FTE), fully qualified GP workforce fell by more than 700 between March 2019 and March 2022.

GP workforce

Meanwhile, NHS England's website makes clear that the additional roles reimbursement scheme (ARRS) is the vehicle for delivering 26,000 staff to support primary care. Its website says: 'To support PCNs, the ARRS provides funding for 26,000 additional roles to create bespoke multi-disciplinary teams.'

The figure of 18,200 more people working in general practice, however, includes 1,441 staff - 8% of the total - who are not in roles covered by the ARRS, but have been brought into 'direct patient care' posts independently of the PCN scheme.

The total also appears to include all staff working in general practice in roles covered by the ARRS - such as pharmacists, podiatrists, advanced practitioners and others - even if they were not brought in through the scheme, but are directly employed by GP practices. A footnote to the figures - published by NHS Digital - says the ARRS roles are 'roles which exist in both the general practice and PCN workforces' and that 'both general practice FTE and PCN FTE...are included in the collated figure'.

GPonline analysis of workforce data collected from PCNs suggested that by the end of March this year, networks had recruited closer to 12,000 staff through the ARRS. The RCGP, meanwhile, warned at the start of 2022 that recruitment through the scheme needed to be stepped up to avoid it falling short of the 26,000 target.

'Misleading' figures

BMA GP committee workforce policy lead Dr Samira Anane told GPonline: 'It’s incredibly frustrating seeing the government misleadingly talk about an increase in GP numbers, when we know the very opposite is true - having lost the equivalent of more than 700 full-time, fully qualified GPs over the same time that the government says we have gained 1,400.

'And regardless of any reported increase in numbers of additional staff, the real test must be in what difference this is making for practices, managing demand, and the experience that patients have.

'Focusing on an overall increase, rather than on accurately capturing the work done by GPs and their teams in a consistent way, tells us very little about what’s happening in practices.

'While a wider practice team made up of a range of professionals can be really valuable, we also know that many PCNs are struggling to recruit and are frustrated by the bureaucracy and inflexibility of the ARRS scheme, meaning the right staff are not necessarily reaching the communities that need them most.'

Call for honesty

The BMA urged the government last year to be 'honest' about the GP workforce crisis - but the government has claimed repeatedly that the workforce is growing, while numbers of fully qualified GPs are in decline.

Meanwhile, data show that general practice delivered an extra 4m appointments in March this year compared to the previous month - with a workforce that dropped by more than 350 FTE fully qualified doctors over the past year.

Health and social care secretary Sajid Javid said: 'I am hugely grateful for the tireless work of GPs and primary care staff who act as the front door to the NHS and provide advice and support to their patients. We have been working closely with the NHS to continue building the workforce and tackle the COVID-19 backlog.

'With over 18,200 more primary care staff already, we are on track to deliver 26,000 more by 2024, backed by record funding to help increase capacity and get patients the care they need more quickly.'

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