The GP workforce - along with the wider NHS medical workforce - has been hit hard across the country by concerns about tax penalties. Across England, just over three quarters of GPs have already reduced their working hours or plan to because of rules that can leave doctors paying more in tax on pension contributions than they earn for taking on extra work.
But in some parts of England, BMA polling shows that almost every GP could reduce the time they are available to provide patient care because of fears over pension tax.
In north-west England, a staggering 48% of GPs have already reduced their working hours and a further 45% plan to. In north-east England and Yorkshire, 47% have reduced their working hours and a further 40% plan to do so.
London is the area least affected, but still faces a massive problem - with 36% of GPs having already reduced their hours and 23% planning to do so, the BMA poll found.
GPonline reported last month on two-fold variations between CCGs in numbers of patients per fully-qualified, full-time equivalent GP. For parts of north-west and north-east England already facing a GP shortage, a reduction in working hours from almost every member of the workforce threatens to be devastating.
BMA leaders have warned that punitive tax charges are severely damaging an already-depleted NHS workforce, threatening a 'massive loss of capacity within the NHS' that places its future sustainability at risk. Both the Association of Independent Specialist Medical Accountants (Aisma) and the BMA have warned that reversing the impact of tax charges on doctors' pensions will require radical solutions.
Although the government is currently consulting on measures to alleviate the problem, the BMA has warned that its main proposal - a '50:50' pension option that would allow doctors to halve the rate at which their pensions grow by halving their contributions - does not go far enough.
BMA GP committee chair Dr Richard Vautrey told GPonline: 'The impact of these punitive pension tax charges is being seen right across the country. Areas with a greater proportion of older doctors may be seeing a bigger impact now, and as you have previously reported, some these areas already have the highest GP/patient list sizes and can ill afford to lose more GPs.
'However as the annual allowance charges start to hit many more younger GPs on an annual basis, unless changes are made I’m sure this will have an increasing impact in other areas such as London too.'
Variations in part-time working between different areas could also influence the proportion of GPs affected by tax charges on pension contributions, with doctors working part-time less likely to hit income levels that can trigger charges.
The BMA warned earlier this year that even doctors aged in their 30s were being forced to reduce sessions or turn down new work to avoid pension tax charges.
A DHSC spokesperson said: 'We are determined to fix this issue to make it easier for our hardworking senior clinicians to balance their workload and pension pot. We are consulting on how we can make NHS pensions more flexible and we will listen to all views on our proposals.'