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GPs go forth

It’s not just a lack of resources that puts young GPs off full-time roles

Editor’s blog

jaimie kaffash 2 duo 3x2

My grandfather Dr John Macfarlane was a GP in Derby in 1948. Like Dr Alun Evans, he was known and respected by his whole community. This came at a cost: my mum recounts acting as an out-of-hours receptionist at the tender age of 10, and – like Dr Evans’ family – of struggling to go on days out as they needed to stay close to the practice.

These days, it is a struggle to convince young GPs to stay in the profession, let alone become embedded in their local community. As the head of Health Education England pointed out last month, four in 10 newly qualified GPs are not working in full-time GP or long-term locum roles. At the same time, the proportion of GPs who are partners is decreasing every year.

These apparent commitment issues are a concern for a number of reasons. We obviously need more GPs in general to cope with patient demand. But we also need partners to run practices.

It’s received wisdom that the state of general practice is the main barrier to greater commitment. And this is undoubtedly a factor. It is not an attractive proposition for younger GPs to see their seniors burnt out and working 11-hour days.

We need bold ideas for a future in which most GPs may not be partners

Yet it’s not stopping F2 doctors from applying for GP training places. This year has seen a record number of filled positions.

It’s my belief that there is a deeper reason for new GPs shunning full-time roles and the decrease in the number of partners. It is a wider societal issue. This is not to jump on the ‘snowflake millennials’ bandwagon – young people work just as hard as their predecessors, often without the traditional reward of property ownership.

The truth is younger generations simply don’t want to stay in the same job for their whole working life and, in many cases, are looking for a more varied portfolio career, including working overseas. This trend is not limited to general practice – it’s evident to some extent across all professions.

The reasons behind this generational shift are too complex to explore here. But the NHS and general practice need to acknowledge it – and it has repercussions. This shift means that even a significant injection of resources into general practice – and it goes without saying that this is urgently needed – won’t necessarily lead to younger GPs taking on partnerships, or even full-time roles, straight after training.

Instead, we need bold ideas for the partnership model, which has been the driver for innovation in general practice. The profession must now innovate to develop the model itself for a future in which most GPs may not be partners.

How it could look is arguably the biggest question facing general practice. In Scotland, this work has already taken place, with the new contract removing partners’ liability for premises and staff. In England, Wessex LMCs chief executive Dr Nigel Watson is leading a review into the model, the outcome of which could well determine the future of the profession.

The days of the Dr Finlays, Macfarlanes and Evans are long gone – but an up-to-date partnership model can help their profession adapt to changing times.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at

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Readers' comments (11)

  • Dear Jamie

    I have said as much in blogs you may have read ?
    The thing is you have POWER-as editor of PULSE you could get all this in the public domain more-remember nobody gives a flying **** what I or any other GP thinks-we are detritus and ignored but you have POWER-please speak up for the turds like us...

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  • It’s not that millennial’s want to work in portfolio careers but that the other options are rubbish. Driven by all the factors that have been laid out over and over again in this forum.
    If the job was fantastic with good pay and pension at the end of it with no saddle of debt and respect from the populous and no fear of being struck off for any mistake made then people would want to do it as much as before.

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  • AlanAlmond

    I don’t really buy into to this idea. People would want to be partners if the rewards were appropriate, they are not. Plenty of people want to be partners in law firms, there’s no crisis of the partnership model there. Why is that do you think? Because being a partner in a law firm is worth all the crap that comes with it. The truth is, being a partner in a medical practice is not worth all the crap that comes with it.
    It’s a nice attractive idea to put this all down to generational changes. That’s bull shit.
    If you go to medical school you are clever and you can work hard. There are clever people working hard in all other walks of life and they aren’t all clamouring to work part time and develop portfolio careers. It’s an issue particularly observable in medicine, and it’s becasue clever hard working people wouldn’t be so stupid as to sign up to a partnership model that takes them for a fool and turns them into a government slave.
    Make medical partnership something the kind of people who do medicine could aspire to and they’ll do it. Continue to treat them as idiots..and they’ll find a creative way to do something else.

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  • The Govt and NHSE want all GPs to be salaried. That is why they are making the partnership model untenable. Once most GPs are salaried Virgin Health, Care UK... will become the normal employers for all GPs.

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  • The partnership model is dead. Long live the partnership model.

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  • Ask any businessman if they would become beholden to one client who could unilaterally change the terms and conditions of their contract and I think you'll get the answer

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  • NHS GP partnership is like being a ‘name’ at Lloyds, except with much lower rewards and you still have to work your ass off.

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  • The government and the press have talked us down for so long, I think we are all just demoralised, profits per patner hugely reduced in real terms. A secondary sector in crisis that we pick up the flack for, agreed bugger all to do with societal change, the job is just constant firefighting (and shite)

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  • it's the double whammy situation possibility in the current partnership model where sign up to a partnership model that turns them into a government slave and also slave to the bullying fraudulent partner(s) in the practice

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    Work to live
    Live to work
    Thank you

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