Urgent funding needed to attract more GPs to under-doctored areas, RCGP warns

The RCGP has called for urgent funding to tackle primary care workforce inequality after a report found deprived areas have significantly fewer GPs per patient - and that the gap is widening.

(Photo: JH Lancy)

There were significantly fewer full-time equivalent (FTE) GPs per 10,000 patients in practices located in areas of higher deprivation, according to the Cambridge University study.

The findings come just weeks after England’s chief medical officer Professor Chris Whitty urged the government to consider whether GP shortages in deprived areas are driven by problems with current GP funding arrangements.

Inequalities were also observed in the overall number of direct patient care (DPC) staff in deprived areas - such as therapists, phlebotomists and paramedics.

GP workforce

However, the report also suggest practices in deprived areas have been alleviating pressure on the smaller GP workforce by employing more physician associates, pharmacists and nurses.

Analysis by the University of Cambridge published in BJGP Open extends a previous analysis on GP inequalities from 2004-2005 to 2013-2014 and updates it to include nurses and additional roles as well as PCN-level indices for GPs and nurses.

The study looked at differences in FTE staff per 10,000 patients between the most and least deprived areas. Its authors said: ‘The finding - that in general there remains a pro-rich inequality in recruitment of staff in primary care - should be of significant concern to policymakers. They will need to consider why practices and networks in deprived areas are relatively understaffed, and how this can be reversed.

‘Significant workforce inequalities exist, and are even increasing, for many general practice roles, with some workforce shortages disproportionately affecting more deprived areas.

‘Expanded use of additional roles under the ARRS may partially alleviate GP workload in overstretched practices, but there is a risk that additional workforce will gravitate to more affluent areas, further perpetuating inequity in primary care staffing.’

Health inequality

Commenting on the findings, RCGP chair Professor Martin Marshall said: ‘A decade of under-investment in general practice means we simply don't have enough GPs to meet the needs of a growing and ageing population.

‘People living in deprived areas tend to have a greater number of long-term health conditions and more complex health needs, and therefore often require greater access to GP care and services.

‘Urgent funding is needed for initiatives to attract GPs to under-doctored areas, as well as recruiting more GPs to the profession overall and preventing the ones we do have from burning out. The college has been calling on the government to urgently deliver on its manifesto pledge of 6,000 additional GPs by 2024.

‘It is more essential than ever that general practice has the workforce capacity to manage both new and existing pressures, so that GPs can continue to deliver high-quality care to patients, wherever they happen to live.’

GP training

A DHSC spokesperson added: 'The government is incredibly grateful for the tireless efforts of GPs throughout the pandemic. We have invested £270m to expand GP capacity, on top of the £1.5bn for extra staff until 2023/24.

'The highest ever number of doctors accepted a place on GP specialty training in 2020 and we are committed to increasing the number of training places available to 4,000 a year to grow the primary care workforce, as well as targeting recruitment in hard-to-recruit areas.

'The new Office for Health Promotion will also launch later this year and will spearhead national efforts to level up the health of the nation and close the gap on disparities.'

BMA leaders criticised recent data from NHS Digital after it changed its methodology for reporting workforce data, arguing it made workforce shortages appear less serious. Analysis of official data by GPonline in May suggested that the FTE GP workforce was 1,307 below the figure for September 2015.

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