Number of GPs continues to decline as 200 leave in three months
The GP workforce in England is continuing to decline, with 219 full-time equivalent GPs lost to the profession since September.
Quarterly data released today by NHS Digital show that although the total number of GPs increased by 328 in the last three months of 2017, when translated into FTE numbers there was a significant decline.
In the 12 months to 31 December 2017, the total number of GPs grew by 228 but fell by 254 full-time equivalent doctors, according to the provisional data.
However, this was a huge improvement on provisional data released in November, that had suggested FTE GP numbers fell by 1,200 in the 12 months to September 2017. NHS Digital has since revised this number to a decline of 404 FTE GPs.
NHS Digital said this was due to how GP registrars are included in provisional statistics released quarterly.
A spokesperson for NHS Digital said the statistics for registrars are contained in the electronic staff record, rather than being provided by practices directly, due to the way they are paid.
However, data from this record are not available until eight weeks after the statistics are compiled by NHS Digital.
But the figures continue to indicate that the Government is way behind on its five-year target to increase GP numbers by 5,000 by 2020.
In the time period from September 2015 to December 2017, the total number of GPs decreased by 60 – or 720 FTE.
This is despite the success of NHS England's induction and refresher scheme, which has tempted 546 GPs back into the workforce since its launch in 2015.
The news comes as a Pulse investigation, published earlier this month, showed a steep rise in the number of GPs claiming their pension early. Since 2013, almost 3,000 GPs have claimed their pension before the age of 60.
It also comes as NHS England missed a target to recruit 600 GPs from overseas by April this year, although NHS England has since claimed it never set this target. In all, NHS England is looking to recruit 3,000 GPs from overseas in a bid to help reach the 5,000 target.
The BMA has warned the Government that continued sub-inflation uplifts to GP pay is going to further exacerbate GP workforce shortages. It has asked the independent review body on doctor's pay to recommend a 2% uplift for 2018/19.
Dr Richard Vautrey, chair of the BMA's GP committee, said GP workforce numbers were 'increasingly worrying'.
He told Pulse: 'Despite the best attempts to increase the numbers by 5,000 we are going backwards not forwards and that impacts on patient care. That impacts on the viability of practices. It means it's so much more difficult to recruit GPs when an older GP retires and it really does need to be tackled.'
He added: 'NHS England needs to make a demonstrable increase in the funding elements of general practice. They need to resolve some of the issues that are barriers to doctors choosing general practice, whether that be the indemnity arrangement or the risks around premises, or the workload.
'We need to do much more to talk up general practice to attract GPs and to retain GPs.'
RCGP chair Professor Helen Stokes-Lampard said: 'For some, the pressure has become too much and it’s genuinely awful that some GPs are prematurely leaving a profession, which, when properly resourced and funded, can be so rewarding and fulfilling.
'But ultimately, it’s our patients who suffer when we lose GPs and we need to make sure that, as well as retaining existing and experienced doctors, measures are taken to attract new GPs to the profession for the future.'
GP workforce in numbers
| Role | September 2015 | March 2016 | September 2016 | December 2016 | March 2017 | June 2017 | September 2017 | December 2017 - provisional |
|---|---|---|---|---|---|---|---|---|
| All practitioners | 34,592 | 34,914 | 34,495 | 34,126 | 33,921 | 33,560 | 34,091 | 33,872 |
| GP providers | 21,937 | 21,597 | 21,163 | 20,835 | 20,702 | 20,499 | 20,234 | 20,128 |
| Salaried/other GPs | 7,292 | 7,436 | 7,295 | 7,300 | 7,390 | 7,359 | 7,603 | 7,802 |
| GP registrars | 4,729 | 5,114 | 5,273 | 5,259 | 4,799 | 4,647 | 5,135 | 4,997 |
| GP retainers | 67 | 78 | 72 | 69 | 81 | 84 | 90 | 108 |
| GP locums | 567 | 690 | 692 | 663 | 949 | 970 | 1,029 | 836 |
Source: NHS Digital
Readers' comments (29)
anonymouse3 | Salaried GP15 Feb 2018 11:20am
'Will the NHS deliver 5,000 extra GPs by 2018?'
Clearly YES, it will deliver them to overseas countries!
Was the the original intention?
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policenthieves | GP Partner/Principal15 Feb 2018 11:24am
'We need to do much more to talk up general practice to attract GPs and to retain GPs.' - wrong end of the stick as usual.
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Council of Despair | Locum GP15 Feb 2018 12:00pm
the DOH will say more money than ever is being spent on the NHS, we have more nurses and doctors than ever and we are aiming to deliver an extra 5000 GPs. GPs are also an important element of the NHS and we (the doh) support the work that they do - so all is well.
the RCGP will support them and say the 5YF view is the right way and work at scale etc etc.
the BMA will support them and fight for a 2% increase in pay as a victory and tell us off for talking the profession down but seriously Vautrey is there anything that you can say to actually talk up general practice without lying? If things are so rosy then let's hear about it?
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Tom Caldwell | GP Partner/Principal15 Feb 2018 12:05pm
GPFV was inadequate if fully delivered. I never thought it was deliverable.
All it has achieved is giving the breathing space from having to have any meaningful engagement in making general practice sustainable and in making the RCGP feel important in engaging with the government.
GPs are as expected voting with their feet.
Would the last GP please turn off the lights... and pay all the bills, sort out the redundancy payments, and talk up how wonderful GP is.
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Tom Robinson | GP Partner/Principal15 Feb 2018 1:06pm
'We need to do much more to talk up general practice to attract GPs and to retain GPs"
Really?
Would honesty not be a better policy
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watchdoc | GP Partner/Principal15 Feb 2018 1:12pm
I am sometimes told to stop complaining and come up with some solutions , ok 1) allow all gps to dispense 2) restore seniority 3) allow us to see private patient s if they want it 4) replace appraisal etc with local accountibility.
Strong leadership is required not endless reviews with ambiguous outcomes and fine words
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Big and Small | GP Partner/Principal15 Feb 2018 1:48pm
5) 'NHS ZERO' - a contract where the GP receives £0 from the NHS but is able to be the registered GP will full access to the NHS tests, prescriptions and referrals that an NHS GP would be able to access. After all the patient is fully eligible for this NHS care.
GPs could then set their own opening hours, fees etc as per the market and each individuals' preferences.
This, in my view, is the only mechanism more money could enter primary care.
If local CCGs wish to provide subsidies to patients who chose this option, perhaps equal a reduced percentage of what they would usually pay primary care for that patient (adjusted for current/expected usage), even better.
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AlanAlmond | Locum GP15 Feb 2018 2:23pm
I’m a mid career GP who Ieft a salaried position in january. I’m still on the performers list and so officially I guess I’m still in the work force, but I’m hardly working and plan to do the occasional Locum to pay my mortgage until I can find something else to do. I wonder what the stats would look like if it took account of GPs on the performers list who aren’t clinically active. Given the absolute personal nightmare it was to get on the performers list in the first place due to the UTTER incompetence of Capita, I suspect there are plenty out there who hedge their bets and remain on the list (out of fear of ever getting back on it) but who aren’t functioning as working GPs. I’d be very interested to hear how these numbers are arrived at. I bet they significantly underestimate the problem if it’s simply based on performers list data.
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Stelvio | Locum GP15 Feb 2018 2:33pm
RCGP is a large part of the problem - supporting the Appraisal and Revalidation farce - a major contributor to older GPs chucking it in; and trying to turn us into Medically qualified social workers
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another last man standing | GP Partner/Principal15 Feb 2018 2:59pm
Yes ,Tom Robinson, honesty would be a good option but in the real world it doesn’t win votes! So the public are led to believe that they can have all NHS services whatever and that is a vote winner until, that is, there is no one left in the workforce to provide the guaranteed services.
If the politicians really can’t see what is staring them in their faces then it’s long overdue that they made an appointment at Specsavers!
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