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Behind the headlines: Admin staff outnumber GPs – but so what?

Behind the headlines: Admin staff outnumber GPs – but so what?

Pulse scrutinises an article in the Daily Mail claiming that receptionists outnumber GPs at over 90% of surgeries. Maya Dhillon looks behind the numbers to uncover what is actually going on, and who or what is to blame.

A recent Daily Mail article has released a ‘shock analysis’ claiming that receptionists vastly outnumber GPs in surgeries across the country. The report goes on to call admin staff ‘idle’ and ‘pen pushers,’ eventually reaching the oh so predictable acme of heaping blame onto GPs and surgeries. 

While there are more full-time equivalent receptionists than GPs in some surgeries, there are overblown claims in the piece. But more importantly: why does it matter?

‘Some practices have 22 backroom staff such as receptionists for every one family doctor.’

On the face of it, this sounds like an interesting claim. But it is not wholly accurate. First, when it says ‘some’, it actually means ‘one’. The practice with the second highest ratio of admin staff to FTE GPs is 14 to one. To imply that multiple practices across the country have 22 backroom staff for every one doctor is misleading. 

The second inaccuracy is that the article flip-flops around using ‘receptionists’ and ‘backroom staff’ or ‘admin staff’ interchangeably. As a result, it claims that ‘receptionists now outnumber GPs at 90% of surgeries’. This simply isn’t true. The NHS Digital data that the article uses to make its point, includes all administrative staff: practice managers, partners, medical secretaries, telephonists, estates and digital staff. In reality, receptionists specifically only outnumber GPs at just under 60% of practices. 

But the implication of the number of receptionists specifically being an issue is clear throughout. The interactive table asks the question: ‘Is your GP practice one where receptionists outnumber the doctors up to 20-to-1?’

‘Critics claimed that practices “have gone overboard on hiring idle workers”, saying “pen pushers are sitting pretty while phone calls remain unanswered”.’

In itself, there are worse journalistic crimes than exaggerating the extent of the admin staff takeover of general practice – the difference between 60% or 90% of practices employing more receptionists than GPs doesn’t change the central point.

But what is the central point? This is where it gets a bit nasty. Because the fundamental argument seems to be to denigrate receptionists and administrative staff. To call these essential employees ‘idle’ and ‘pen pushers’ is disrespectful in the extreme. Receptionists have become even more critical in general practice in the past decade. Not only are they the front door to the ‘front door of the NHS’ – and therefore having to deal with all patients – but nowadays they act as a first form of triage for GPs.

The Daily Mail goes on to criticise this very point: ‘Patients might feel like they have no choice but to describe intimate health matters to receptionists in order to justify getting a GP appointment’. While one can be sympathetic towards a patient having to divulge health information over the phone, what the article fails to consider is that this is a very necessary step that is designed to keep waiting lists down. It may be that a patient’s condition doesn’t need examination by a GP and could be addressed by a consultation with an ANP or a pharmacist, thus reducing the GP’s workload. On the flipside of that, it streamlines the patient’s treatment – getting them to the place they need to be faster.

‘Insiders estimate general practice as a whole is short of around 7,000 family doctors, who earn six figure salaries, on average.’

It is true that there is a shortage of GPs – Pulse has led the way more than anyone in highlighting this. It is also true that GPs earn more than the average salary. But this line seems to be suggesting that the workforce shortage and GP pay is linked. And it is, just not in the way the Mail suggest.

First, there are plenty of reasons that high salaries for GPs are justifiable. Their ten-year education and training in a highly-skilled role (with the tuition fees that come along with it) see them as more worthy than, say, bankers for such a salary. 

Even more importantly, one of the reasons that GPs are paid this amount is because – as the Mail itself points out – there are fewer GPs to share the funding round. GPs can work up to 13-hour days with a relentless barrage of demands. If they’re not seeing patients (on average a whopping 37 a day), they are doing admin, prescriptions, requests from secondary or community care etc. As the workload dumping ground of medicine, it’s worth a wager that many GPs would take a lower salary if it meant that their workload was significantly reduced.

The six-figure income tend to be limited to partners, who have to bear the brunt of this (and the inevitable burnout that follows). For salaried GPs – who have their fair share of burnout too – the average salary is a far more modest £68,000 a year on average.

‘There are now just under 41,000 FTE receptionists employed across all GPs services in England, overall NHS figures show. When modern NHS records began in 2015, the toll stood at around 33,000. GPs, who now usually work around three days a week and pocket six-figure salaries on average, have failed [to] keep pace.’

Where to start? Receptionist numbers have risen because they needed to. General practice needs more people in all areas of the workforce. We are dealing with an ageing population with complex and often comorbid conditions. We need receptionists and admin staff to field patients’ calls, deal with paperwork,  and, as already stated, triage patients. Complaining about having more receptionists fails to recognise the scale of the crisis in general practice – we need more people everywhere. 

Saying that GPs have ‘failed’ to keep up with these numbers reveals a gross negligence to understand the landscape of general practice. It places the blame squarely on GPs and practices, when in actual fact the finger should be pointed at the Government (which the Mail has consistently supported). The policies introduced over the last 14 years have done nothing to ease the life of GPs, and everything possible to aggravate it. In particular, one can note the general underfunding of the profession and a misunderstanding of how general practices operate. The measly 1.9% uplift offered in the 2024/25 contract was wholeheartedly rejected by members of the GPCE in the April referendum. There isn’t enough money on the table to hire GPs. Following on seamlessly, the ARRS scheme doesn’t include GPs. This means that many practices, already underfunded, have no choice but to hire non-GPs.

All of this means that there are fewer GPs in the system. With fewer GPs, those that remain have a higher number of patients to see, and by extension a greater workload – 55% of GPs said that they struggled with their workload in comparison to 38% of all doctors. Consequently, this leads to high levels of stress, moral injury and burnout – the same GMC report found that GPs had the highest risk of burnout compared to other doctors (31% compared to the average of 25%). That then results in more GPs reducing their clinical hours, moving abroad, going private or even retiring early – leaving more gaps in the workforce because of… fewer GPs. It is a vicious cycle that needs a radical intervention by the Government – it is not the fault of practices for not keeping up. And it certainly has nothing to do with the hiring of receptionists, or other admin staff.



Please note, only GPs are permitted to add comments to articles

John Graham Munro 25 June, 2024 6:13 pm

Whenever I run a surgery with no staff, you can hear a pin drop

Monkey Typing 25 June, 2024 6:43 pm

PULSE please get a grip and get rid of this idiot. I can not be the only one who is thoroughly bored of their relentless narcissism . Its the kind of never ending bullshit that comes out of Russian troll factories. The only purpose being to piss everyone off. Whoever this person is you need to stop them using your platform to rehearse their mental health issues and distort and stifle debate. Really people are reading this crap, rolling their eyes and thinking..not posting here. Ive not read a single comment from this account that wasn’t deliberately provocative and referring to something about him/herself. Bin this prat. Please.

Charlotte Alexander 25 June, 2024 6:51 pm

Admin staff have a nice room with plants and their own desk decorated to their taste , a nespresso machine . Us clinical staff slum it in a room with a kettle and a sink

John Graham Munro 25 June, 2024 6:54 pm

Re Monkey Typing
Don’t worry——-I’m already on Mr. Kaffash’s hit list for the second time

Scottish GP 25 June, 2024 7:35 pm

JGM, thought you had retired/left/died. What would we do without your pithy inciteful wit?

David Church 25 June, 2024 10:15 pm

Yeah, So What? They always did.
Even in the days when a Practice was a single-handed GP supported by a spouse and 3 children, there were always more children to answer the phone than there were GPs on the staff !
Not quite sure why Charlotte has a kettle in her Clinical room : is it a Nelson inhaler ?

Post Doc 26 June, 2024 1:35 pm

Every practice should have a tea trolley. And a member of staff to push it.