GPs per patient slump as NHS medical workforce '25 years behind EU', BMA warns

England's medical workforce is 25 years behind comparable EU nations according to a damning BMA report that warns GP numbers are below a worst-case prediction from government advisors in 2014.

BMA analysis of the medical workforce crisis facing the NHS shows that across primary and secondary care England now has just 2.8 doctors per 1,000 patients - compared with an average of 3.7 in comparable EU nations.

The doctor-to-population ratio in England is lower than any other OECD EU nation apart from Poland, according to a BMA report setting out the findings. The report warns the chronic doctor shortage means the 'very existence of our NHS is thrown into jeopardy'.

In general practice, the report says 'we have 1,307 (4.4%) fewer fully-qualified full-time equivalent (FTE) GPs than we did in September 2015'. With patient numbers rising, there are now just 0.46 GPs per 1,000 patients compared with 0.52 in 2015 - a drop of around 13%.

GP workforce

The report warns that despite record numbers of GP trainees now in the pipeline for general practice - the GP workforce is currently on track to fall below the worst-case scenario predicted in a 2014 report commissioned by the government from the Centre for Workforce Intelligence.

The report questions the likely impact of a government promise to recruit an extra 6,000 GPs by 2024 - suggesting that even if an extra 6,000 doctors are recruited to general practice they will translate to just over half this number in FTE terms.

The report says that careers in general practice are 'increasingly popular among young doctors', but that there is an 'urgent retention issue with GP partners' - pointing to a 22% drop in FTE GP partners since September 2015.

The report also highlights 'a clear trend towards salaried and sessional GP roles and more portfolio and less than full-time working' - warning that general practice needed 'nearly three salaried and sessional GPs (headcount) to replace the hours lost due to a reduction in GP partner numbers and changing GP working patterns between March 2020 to March 2021'.

NHS reform

BMA leaders have called for the Health and Care Bill currently going through parliament to include a requirement for the health and social care secretary to publish regular workforce assessments, for increased funding for the medical workforce and investment in retention.

Dr Latifa Patel, acting chair of the BMA representative body and chief officer workforce lead, said: 'It’s unforgivable that government has allowed the NHS workforce crisis to get to this point. Today’s report not only highlights the sheer scale of doctor shortages in England, but also how woefully unprepared the nation is to meet the healthcare challenges of the future.

'It’s frightening that we’ve reached a point where we’re short of 49,162 FTE doctors, but even more terrifying to think that this number could hit 83,779 by 2043, as our research suggests. If this crisis is left to deepen, more patients will go without the care they need, their safety will be threatened, and existing staff will be pushed to the limit like never before, driving yet more talented healthcare professionals out of the NHS.

'It’s clear that previous attempts to increase staffing levels have failed to bridge the gap. In primary care alone, the overall qualified GP workforce has barely grown since 2015, with the number of GP partners falling by the equivalent of more than 900 full-time doctors in the most recent 12-month period.'

Medical training

Dr Patel urged the government to listen to calls for more investment in training places, and warned that 'putting just as much emphasis on retaining staff as recruiting new colleagues is quite frankly, common sense'.

Royal College of Physicians president Dr Andrew Goddard said: 'There is no doubt that the NHS needs more staff and we need to act now. More than a quarter of our experienced senior consultants are planning to retire in the next three years, and 56% of trainees have told us that they want to work part-time. The population is ageing and patient demand is growing.

A DHSC spokesperson said: 'This government is committed to supporting the NHS and its staff in the fight against COVID-19 and beyond.'

The spokesperson said there were more than 1.19m doctors, nurses and NHS staff and that there were 'more medical students in training than at any point in NHS history'.

They added: 'We are committed to increasing the number of training places available for GPs to 4,000 a year, and we have the highest number of doctors accepting places to train as a GP.'

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