One in three licensed GPs not working in NHS general practice, study finds

One in three GPs with a licence to practise in England are not working in NHS general practice, a new study has found.

The research, published in the BMJ, suggested that newly qualified GPs are not entering the NHS general practice workforce or are leaving within the first 10 years.

The researchers set out to compare the numbers and characteristics of GPs across three national sources of workforce data – the GMC GP register, the GP performers list and NHS England general practice workforce datasets published monthly – to examine trends in GP numbers relative to population growth and the specialist medical workforce in England.

They found that, on average, for every five additional GPs licensed by the GMC, general practice lost one full time equivalent GP each year for the period 2015-24.

As a result, the proportion of licensed GPs not working in general practice increased from 27% (13,492) in 2015 to 34% (19,922) in 2024 by headcount and from 41% (20,210) to 52% (30,351) by full time equivalent GPs.

According to the authors, the findings highlight a widening imbalance between primary and secondary medical workforce capacity and ‘a critical need’ to address the underlying reasons for workforce attrition in general practice to achieve the Government’s ambition to move more care into the community.

The researchers highlighted some of the barriers faced by GPs looking to enter general practice, including the unemployment crisis.

They said: ‘Barriers to entering NHS general practice need to be looked at, particularly with recent reports of GPs unable to find NHS general practice work despite a well reported need for these GPs.

‘This situation has been attributed to earmarked funding streams incentivising the employment of other direct patient care roles in general practice, such as pharmacists, physician associates, and paramedics, rather than GPs.’

They also said that other ‘push factors’ for GPs leaving the NHS included: having insufficient time with patients; loss of continuity of care; administrative burdens; unsustainable workloads; feeling unsupported, and being burnt out; as well as problems with pensions and income.

Citing Pulse coverage, the research also listed some of the reasons why GMC licensed GPs are not on the Performers List, including because they are working only in private practice.

The paper concluded: ‘The overall proportion of GMC licensed GPs not working in NHS general practice has risen, now representing more than a third by headcount count and more than half by full time equivalent GPs

‘The growing difference between GMC licensed GPs and those working in NHS general practice is in contrast with trends among specialists.

‘This shift is occurring despite rising patient demand and policy commitments to strengthen primary care.

‘Addressing the underlying reasons for workforce attrition in NHS general practice is critical to achieving the government’s stated goals of strengthening community based care and shifting the focus of care from treatment to prevention.’

Earlier this year, Pulse exclusively revealed that almost 40% of GPs see themselves leaving UK general practice in the next five years.

And a Pulse investigation laid bare the ongoing unemployment and recruitment crises in England, which involved GPs out of work at the same time as practices facing a 16% shortfall in GP numbers.