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At the heart of general practice since 1960

GPs in London more stretched than rest of UK, claims trade union

The number of patients per GP is higher in London than the rest of the UK, despite far greater demand for training placements in the capital, a new report has revealed.

Research commissioned by the trade union Unite found that London has one GP per 1,576 people, compared with a national norm of one GP per 1,441 people.

This is despite an oversubscription for training places in the capital, which last year saw 3.7 applicants for each training place in the capital, compared with an average of 1.6 outside of London.  

Unite also found that, in a quarter of London CCG areas, more than 20% of GPs are aged 60 or over.

It called on Health Education England to develop a strategy with the city’s three local education and training boards to increase the number of GPs in the capital.

The report, London’s NHS at the crossroads, found ‘an unravelling of services as the NHS becomes more fragmented and financially squeezed’ in the capital and called the creation of an overarching health authority to oversee strategy among London’s 32 CCGs.

It said: ‘We recommend the creation of a new type of London Strategic Health Authority, on a model which does not replicate the former structure of NHS London, but which encompasses a democratic element, possibly with involvement of the Greater London Assembly, London boroughs and CCGs.’

It also argued that ‘different levels of care’ are currently being commissioned by adjacent CCGs, leading to ‘unequal treatment of patients on the same ward’, including support for new mothers who are breastfeeding.

London GP Dr Louise Irvine, who is on BMA Council, was an advisor for the report.

Readers' comments (12)

  • Ivan Benett

    It is high time we all started promoting General Practice to the next generation and co-operating with local Deaneries to get workforce plans working effectively. Too often we shoot ourselves in the foot, as a profession, by being deliberately obstructive to those who are trying to help us plan for the future, or denegrate General Practice and sneer at positive developments. Skepticism has it's place, but pure cynicism and negativism is pure turn off for those we want to attract.
    Modern young doctors are looking for flexibility, variation and choice. So that's what we have to offer them, or they'll vote with their feet...as they are doing.

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  • Says Ivan, government lackie encouraging 7 day opening. Behave yourself......

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  • "GPs in London are more stretched", because they don't take more partners and would like to further exploit salaried

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  • Vinci Ho

    (1)I genuinely believe our colleagues in London are very stretched but it is difficult to say 'more' as we are talking relatively . Other regions have their own special circumstances.
    (2) correct me if I am wrong. I call it Capital Syndrome -- behind the glamour and prosperity, there is always crime , addiction , deprivation and poverty .Look at other countries -- Paris, Cape Town, Rio, Amsterdam.....New York is probably the only one not capital. Of course , job of GP is hard!
    (3) It is called 'losing face' if a government admits the capital is 'worse off'. Hence , our colleagues are 'naturally' not getting help they need.
    (4) Even more spins of politics because politicians and bureaucrats keep coming up with 'brilliant' politically correct ideas.Call it capital politics.
    (5) People like Louise are fighting hard , best of luck......

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  • Simply not true to say London is more stretched then other parts of the UK, I suspect there is a large majority that is very very stretched across the entire country. With the fragmentation of services much of the NHS feels as if its on the verge of collapse.

    I'm not sure if some services such as psychological services and CMHT should stop pretending that they can provide adequate cover and should openly define what they can provide. AT least that would allow for some clarity, and stops the conversation about what should be provided vs what can actually be provided.

    To Ivan although I agree with your sentiments, young doctors coming out with significant debts are very clear about what they want. We should not be lying to them. If the profession is in a healthy state it'll attract good doctors or the continued trend of dr's leaving these shores will continue.

    The negativity is not a reflection of cynicism but just a true representation of where we are. It'll only hit home when primary care collapses in parts of the country and everyone will be asking why.

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  • Shock, horror, no-one wants to work in a place where a grotty 3 bed flat costs half a million and you can't be a partner! Doctors wages have now fallen so low, they can't afford to work in central London any more, the over 60s having arrived before house prices went a bit silly. Sadly it will be almost impossible to replace the retirees with newly minted GPs. It's going to be very interesting to see what happens to property values when certain areas of London loose access to primary care.

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  • I work as a partner in Central london, we are a reasonable high earning practice and I can only afford a small 2 bedroom flat ( zone 2)... Regarding the strain.... Due to it being a metropolis it has it's own unique problems, due to social isolation, terrible housing problems as well as having an unbelievably diverse population. I enjoy it but when I start to think about having more kids and schooling it all goes a bit pear shaped

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  • Most public sector jobs include London weighting- a premium to reflect the increased cost of living in London. Housing, food, transport, and services are more expensive. GPs have a national contract which makes no such allowances.
    The expenses of running a practice in rural areas can be higher, with lower lists and a more spread out population, but this is accounted for in global sum with Carr Hill formula.
    We are heading for a major car crash all over the country.
    Bob, your comments please?

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  • The commissars continue to preside over the collectivisation of primary care.We all know in Soviet Russia this lead to agricultural collapse,and so it will happen in Primary care.

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  • Bob Hodges

    Well all this is starting to look like an excuse for Whitehall to dream up another whizz-bang 'London Solution' for a non-existent Gloucestershire Problem.

    I don't doubt that London has unique challenges, but so does everyone else. None of this can be solved by cutting budgets, and each requires a 'local solution'. In essence WE'RE ALL DOOMED!

    The point about glorious 5 year plan collectivism workers control the means of production etc etc is moot.

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