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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

 RoleSeptember 2015March 2016September 2016December 2016March 2017June 2017
September 2017December 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)

  • '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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  • '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

    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

    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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  • '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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  • 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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  • 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

    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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  • 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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  • 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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  • Workforce "Challenges" will not be adfressed by current BMA and Dept.of Health activity! Suspect that is the Real Agenda -to demoralize and decimate the GP Workforce and then Shift Blame for NHS Collapse onto "Greedy GPs". NO Sign of Alternative Explanation!

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  • We need more locums.

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  • Why on the one hand does the BMA blame the government for poor GP moral on below inflation pay rises, when the BMA is only lobbying for a 2% increase?

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  • Our Health boards in Wales pays Locums much more than the locally agreed rate --- so we can not get Locums....have only taken just over 50 % of my annual leave allowance in the last 12 months ...that is not sustainable.

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  • Do you really want to be working with ever dwindling resources and then being charged with manslaughter when things go horribly pear shaped?

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  • Is it time for the country to serve a penance Mr Hunt,one that will not end.The UKs deal with medics is at least uncompetitive,on the basis of the last week or two it is abusive and exploitative.Quite a legacy brewing for the Tories,a party that by its own demographic is becoming increasingly likely to become extinct.

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  • Suspect it's worse than the figures suggest.... I informed NHSE that my status would change from full time principal to locum 3 months before I planned to do so ( mid August ). This was acknowledged just before Christmas, some 7 months later. All of my mates in their early to mid 50's are heading for the exit, a perfect storm brewing, well done Mr Hunt

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  • The GMC is utterly without humanity. A 1st class doctor [ Physiology ] is hounded after working for 4 people. Working for 1 is really 2 so that is about 8 doctors work [ 13 hours without a break], then a criminal.
    The message should be clear to all ' You will be worked to death or jail'
    Please avoid Medicine in the UK. Leave if you have not already.

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  • Just Your Average Joe

    Need to face facts 1 Full time GP male partner out - needs 2-3 part time/locum, very possibly might consider salaried options, Out of post/maternity/career break/Australia etc, replacements.

    The fantasy of 1 in and 1 out is a shattered piece of DOH fallacy and wishful thinking.

    Reverse all the reasons why older GPs leaving and there might be a hope and it would be that expensive to implement, as the money from it has been only recently grabbed in taxes and redistributions. Others are just free and reverse policies bashing GPs.

    -Start with appraisal and revalidation
    -seniority payments (value experience)
    -Lifetime and annual pension allowances for those who would like to remain in this ponzi scheme
    -Scrap the manslaughter with hunts and change the law so overwhelming negligence only can be a cause of investigation - where, a panel of doctors advises if this level of incompetence and negligence has occurred before a prosecution can proceed in case where it truely needed.
    - GMC and CQC and MDU/MPS fees
    -Scrap CQC
    -Stop the privatisation and APMS agenda to force out GP's

    Actually invest in the most cost effective part of the NHS which allows the rest to work.

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  • Agree. Look at any random surgery website and at the top you find a couple of males in their 50s (FT) running the show. Beneath are a shower of part timers with special interest in appraisals etc. 3 of these needed for one of the former.
    Then look at your surgery. Everyone is aged 72. They are all going to get ill in the next 15 years and expect top class home treatment. It is going to get worse before better.

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  • Wait! What happened to those colouring pens & drawing pads from the RCGP? I think we all need to get those back out again.

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  • I cannot understand the blindness of “GP leaders”, especially the RCGP. You insult me by appraisal and revalidation and that’s one thing which will make me leave. It’s pretty obvious but seems to be the elephant in the room. I know many doctors my age (58) quote appraisal and revalidation as a major factor in their leaving. I’m certainly not going to be revalidated again so I’m going 3 years maximum, that’s if I can cope that long.

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  • haluk salih Christopher Heath • 24 minutes ago
    It is absolutely disgusting how our representatives do bugger all and completely ignore what state we are in. Token gestures here and there yes, but at the end of the day slaves to their careers and the government.
    The bombardment of additional unpaid work each week is the reason for the decline as well as the unnecessary excessive surveillance brought in by the Government. Every single new Nice guideline, every single new drug alert or some new fancy local policy serving the pockets and egos of others means a huge amount of work created either undoing what you have done or implementing a new regime for care and recalling them all back in again to get back in line. This goes on weekly if not daily. What if we ignore the overwhelming information and indeed find we are so stressed by our workload and lack of staff that we forget to implement any of these changes??we get done for manslaughter. Wonderful life, what the hell am I still in this career for? Just be a locum, pop in, send them for blood tests or a 2ww go cover yourself from blame then leave the mess to the few burnt out remaining partners to follow up. Take your money and go home safely knowing you have absolutely no responsibility for what happens thereafter, you have after all implemented the safety strategy. Sounds like a better option to me because I cannot see any of you lot standing up and being counted in this debate.

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  • “ go and be a locum” if only a half of all the gps leaving age 57 ( the average round here) did that it would be a huge help, and perhaps far better than trying to get docs in from very different gp cultures.

    Keeping experienced gp’s in the workforce by minimising irritations such as appraisal and stupid policy and IT changes, ie FGM policy 😱etc

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  • sadly the transformation and unsustainability "plan" is set to fail, you can keep on reducing referrals to near zero and use the cheapest medicines and then the gains stop.the population is getting older and more complex and we are being asked to look at patients with more complexity, see more and keep patients at home and take more risks.the governments next stage is to make the gps and ccgs fully accountable for the money-a £5 to cover all the patients and you pay yourself from this.just like a train franchise.plus they want us to cover nights and weekends in large gp practices.meanwhile all the risk is taken by the doctor and the medical defence the doctor has, not by the system.the nhs will soon be detrimental to your career and you wonder why so many people try to do admin jobs for ccg or bma or rcgp. when there are so few gps or gp assistants or nurse practitioners they will have to use push doctor to fill in areas of loss.if I was a young gp I would look abroad or part-time only.it is great to treat lovely people, but its not great to make more mistakes and fail these people.

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  • New SNP tax changes North of the border is certainly going to help the rural and Scottish GP recruitment crisis!
    Along with the new Scottish contract. 10 years of the SNP.
    No further comment

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  • The NHS was never disimilar to an old car. Give it an annual MOT and service. A little bit of rust? No problem. Leave it in a barn then it will rust and corrode to the point of no return. GPs were never part of the solution either. More specialists to the denigration of GPs when they needed more generalists. Lets see what happens from now on. There are far too many specialists the NHS and not enough generalists. That is the problem.

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  • Sad reality is even if conditions worsen a lot more like 3x raise in defence fees, GMC, CQC Fees....a significant proportion will still remain to serve the NHS.

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  • Gp trainees who have done akt, appraisals and 3 years of training along with gp exams have to clear a bullshit acting Csa exam. Where you have no idea why you failed as there is no video evidence. And the leaders talk about lack of GP. Don’t the leadership see the Csa exam is an utter farce ? Or are they blind ?

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