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England could need three new GPs to replace each retiring partner, finds BMA study

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A BMA workforce study has found that each outgoing GP partner may need to be replaced by three new GPs due to shifting working patterns.

It comes as the pandemic is prompting more GPs to reduce their clinical hours or take early retirement.

The BMA report said that nearly three salaried and sessional GPs were needed to replace the hours of one GP partner between March 2020 and March 2021, due to a ‘shift in GP working patterns’ combined with the loss of partners. 

It added that while there is an ‘urgent retention issue’ among GP partners, careers in general practice are ‘increasingly popular among young doctors’.

The report said: ‘There is a clear trend towards salaried and sessional GP roles and more portfolio and LTFT (less than full-time) working.

‘We needed nearly three salaried and sessional GPs (headcount) to replace the hours lost due to a reduction in GP partner numbers and changing GP working patterns between March 2020 to March 2021.’

The report said:

  • The salaried and sessional GP workforce increased by 1,807 between March 2020 and March 2021 but the headcount number of GP partners decreased by 546 – resulting in an increase of just 111 FTE GPs
  • There are now 1,307 (4.4%) fewer fully-qualified FTE GPs than in September 2015, while the number of patients per practice is 22% higher – meaning there are now just 0.46 fully-qualified GPs per 1,000 patients in England compared with 0.52 in 2015
  • 18% of GPs will reach minimum retirement age in the next 10 years
  • The BMA only anticipates getting around 3,380 additional fully-qualified FTE GPs out of the 6,000 additional GPs promised by the Government by 2024, without factoring in any existing GPs reducing their hours or leaving the profession.

An anonymous GP partner told the BMA they are ‘routinely having to handle 120 new calls a day in the practice [and are] unable to afford locums’. 

They said: ‘[It is] very difficult to recruit partners as the pay is so much lower than it used to be. Salaried staff need protecting, so cannot respond to times of high workload.’

In a statement, the BMA also said that the number of primary and secondary care doctors per 1,000 people in England is ‘25 years behind comparable European nations’, with almost 50,000 extra doctors needed to ‘meet the country’s current healthcare challenges’.

BMA research found that there are 2.8 GPs and hospital doctors per 1,000 patients in England, compared with an average of 3.7 in ‘similarly developed EU countries’, it added.

England has the second-lowest doctor-to-patient ratio than any other comparable EU nation after Poland and not a single area in the country has 3.7 doctors per 1,000 patients, it said.

The BMA added: ‘Not only does this shortfall impact patient care and safety, but it also puts immense pressure on existing NHS staff, many of whom are being stretched to the limit and forced to take on extra, often unpaid work to make up staffing gaps.’

The report added that due to the workforce shortages, each FTE doctor in the NHS currently works on average 1.3 FTE roles, equivalent to an additional 11-12 hours extra per week.

Acting chair of the BMA representative body and chief officer workforce lead Dr Latifa Patel said: ‘It’s unforgivable that Government has allowed the NHS workforce crisis to get to this point.

‘[The] report not only highlights the sheer scale of doctor shortages in England, but also how woefully unprepared the nation is to meet the healthcare challenges of the future.’

The BMA is calling for:

  • The Health and Care Bill to require the health secretary to publish ‘regular, detailed and publicly available health and care service workforce assessments’
  • Increased investment in further medical school, foundation programme and specialty training places
  • Investment in retention initiatives such as ‘removing punitive pension taxation rules so older doctors can remain in work flexibly’

Meanwhile, NHS England last month told PCNs they will need to free up work space to ‘accommodate’ taking on more staff recruited through the Additional Roles Reimbursement Scheme (ARRS).


John Graham Munro 16 July, 2021 1:01 pm

And that’s the problem isn’t it?—–locums have to be paid as well as the partner’s holiday——despite being able to grow an extra pair of hands and be in two places at the same time——in other words clearing up the mess the incumbent has left behind——a resilient non complaining work force—– because they take breaks see

Dr N 16 July, 2021 5:24 pm


Do you play a game where you have to fit ‘locum’ somewhere into a sentence even if its irrelevant?

John Graham Munro 16 July, 2021 11:13 pm

Dr N——–It’s not a game——‘locums’ will become more ”relevant” in the coming weeks—–I’m not often wrong about things, although I did predict Bojo would have been gone by the Spring

Charles Richards 19 July, 2021 4:18 pm

The value of goodwill revealed. Will NHS wake up to what the real costs of a salaried work-to-rule service will be?