GP workforce stalled over past year as slump in partners continues

The number of fully-qualified, full-time equivalent (FTE) GPs in England has barely changed over the past year despite government promises to grow the workforce, official data show.

GP workforce (Photo: Robert Johns/UNP)

There were 27,699 fully-qualified FTE GPs in September 2021 - down three from the total a year earlier, and down 187 compared with September 2019, according to figures from NHS Digital.

Numbers of FTE GP partners remain in rapid decline - with a 3% drop over the past year, analysis of the figures by GPonline shows. There were 16,922 FTE GP partners in September 2021 - down 546 from a year earlier and 1,340 over two years.

Salaried GP numbers have risen rapidly over the past two years, the data show - potentially reflecting doctors switching from partnership and locum work. GP trainees are also up sharply - 8,576 in September 2021 compared with 7,454 in post at the same stage in 2020.

GP workforce

The latest figures come just days after health and social care secretary Sajid Javid told MPs that the government was set to miss its manifesto pledge to increase the FTE GP workforce by 6,000 by 2024.

Falling GP numbers alongside soaring workload in general practice was cited by the BMA's GP committee as a key factor that has pushed the profession to the brink of industrial action in the wake of the poorly-received access plan and support package published by the government and NHS England last month.

Committee chair Dr Richard Vautrey said: 'GP numbers are falling, and the total number of patients continues to rise. The workload, even without addressing the backlog, is now more than we can realistically and safely manage.

'Patient care is suffering as a result. It’s important to stress that these actions are not directed at patients, nor the care they receive, but absolutely at the government and NHS England, and in the interests of patient safety, they must act now to stop the abuse, reverse the unsustainable workload and address the burnout felt by so many GPs and their teams. When you add to that the levels of bureaucracy we are expected to cope with, the time has come to say we cannot go on like this anymore.'

Unsafe workload

The BMA has also hit out at a recent change in the methodology used for counting the GP workforce, which means NHS Digital no longer includes estimated figures for practices that fail to submit data - a move that has made reductions in the workforce over the past five or six years look smaller.

BMA estimates based on the previous workforce methodology - which remains under review by NHS Digital - show a significant drop in fully-qualified GP numbers over the past year.

BMA GP committee executive team member Dr Krishna Kasaraneni said: 'Today, we still have around 300 fewer full-time equivalent, fully-qualified GPs in England than we had a year ago. And since 2015, when ministers first began making promises about increasing GP numbers, England has lost the equivalent of more than 1,700 full-time, fully-qualified GPs.

'While new doctors may be choosing general practice, this is not keeping up with the high numbers of GPs leaving or reducing their hours in the face of unsustainable, unsafe workloads and rising hostility against the profession. Meanwhile, confusing and damaging pension taxation rules that punish senior doctors for working more are a barrier to their ability to provide care to patients – something the chancellor failed to address in the recent spending review.'

NHS staff retention

BMA workforce lead Dr Latifa Patel said this week that retention of doctors in the NHS should be the 'absolute focus' for the government.

Dr Patel said: 'Mr Javid himself admits that the government is not on track to deliver the additional 6,000 GPs that his own party promised in its election manifesto - something we have been warning about for years. The health secretary talks about increasing numbers of medical students, which, though much-needed, will take at least 10 years to produce new fully-qualified GPs and a minimum of 12 years for consultants.'

Asked about falling numbers of GPs in partnership roles, Mr Javid told the House of Commons health select committee this week: 'I do think we are getting to the point where we need to take a fresh look at this. If there are things that are getting in the way of becoming a partner or becoming a salaried GP in a particular practice we need to work out what those are, listen to the GPs and make sure we are reacting.'

Mr Javid also appeared to repeate a claim featured in the controversial GP access plan about GP numbers that was condemned by doctors' leaders as an example of 'misleading' government statements that downplay the extent of the GP workforce crisis.

GPonline reported last month that the access plan said there were 'now over 1,200 more full-time equivalent (FTE) GPs than two years before' based on figures for June 2019 compared with figures for June 2021.

However, the figures include trainees - masking the fact that the fully-qualified FTE GP workforce increased by only 101 over this period. Meanwhile, the fully-qualified FTE GP workforce fell by 986 between March 2016 and March 2021, a 3.4% drop.

NHS Digital figures for September 2021 are based on responses from 99.6% of GP practices in England, with figures for the previous two Septembers also based on data from a similar proportion of practices.

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