the great escape cover pulse final 3×2
Plans to increase the GP workforce seem doomed to fail.
With a year left to reach the Government’s target of having trained and retained an extra 5,000 GPs since September 2015, overall numbers are in fact falling.
As of September 2018, the number of full-time equivalent GPs was still 387 below the 34,592 in the workforce in September 2015.
Pulse revealed back in February that a compelling reason for this trend is more GPs are retiring and drawing a pension at a younger age.
Official NHS pension scheme figures showed that in 2016-17 some 721 GPs under 60 drew their pension for the first time, a 41% of increase on the 2011-12 figure of 513.
The average age of pension claimants fell from 60.4 years to 58.5 years in the same period.
While the latest figures on the number of GPs retiring early show some signs of improvement – in 2017-18, a total of 588 drew their pensions before age 60 – GPs have still warned that unless the problems of workload and stress were addressed GPs would continue to opt for early retirement.
And the upshot? Despite more trainees than ever before entering the profession, incentive schemes to bring leavers back into it, and the NHS boosting numbers of GPs from overseas, early retirees are tipping the balance the other way.
As a result, pressures become even greater on GPs left holding the baby, as they try to keep their practices together.
In some areas, supply fails to meet demand and practices end up closing, leaving thousands without a GP.
In others, workload is reaching potentially dangerous levels – with GPs having 60% more patient contacts per day than the European Union of General Practitioners considers safe.
Paradoxically, workload pressures are not just a consequence of GPs retiring or cashing in their pensions before their turn 60. They are also the leading cause.
Early retirees cite workload above all else as a factor in their decision, and half of respondents to a Pulse survey said work stress affects their ability to care for patients.
Other reasons GPs give for retiring early include: poor mental health; high indemnity costs and taxation; regulatory burden; a 15% annual slash in seniority payments (ahead of their abolition in the next year); and fear of being the ‘last (wo)man standing’, which would see them lumbered with premises and staff liabilities with no one rising through the ranks to take them over.
Earlier this year, the BMA said it was looking at potential solutions, including launching an initiative aimed at dissuading GPs from taking early retirement.
But this will only work if the bigger issue of making general practice an attractive place to work is addressed – so that more young doctors enter the profession, and fewer leave before their time.