Even locums in the shires are holding their rates back for fear of losing work.
Newly qualified registrars trying to establish themselves are hardest hit.
‘There are huge concerns and the registrars are especially anxious,' said Dr Richard Fieldhouse, chief executive of the National Association of Sessional GPs.
Locums in Kent and Bristol have not raised their rates for three years, he said.
‘Whether it's real or imagined, locums are very nervous of changing their rates. No-one is putting them up.'
The dearth of partnerships and openings for principals has driven new GPs into the freelance market and kept them there for longer, Dr Fieldhouse said.
‘Nice cathedral cities and market towns have always been difficult to get into. But now I understand that even inner city practices are no longer struggling as they used to.'
Dr Fieldhouse has extended his own travel time to keep the work coming in.
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