Latest GP headcount still not enough to resolve current crisis, says BMA

Author: Caroline White

The total number of GPs in the workforce has risen, but the overall numbers of fully qualified and full-time equivalent GPs has fallen, compared with March last year, preliminary figures* issued by NHS Digital show.

This latest GP headcount still falls well short of what’s needed to resolve the current workforce crisis facing general practice, the British Medical Association (BMA) has warned.

The figures show that the total number of GPs, including those in training, rose by 0.8% (350) compared with March last year, as did the total number of full-time equivalents, rising 0.9% (312) to 34,736.

But the number of fully qualified GPs fell by 1.3% (494) to 38,685 over the same period, while there were 441 (1.5%) fewer fully qualified full-time equivalents in March 2019 at 28,697.

The rise in total numbers was very welcome, but “nowhere near sufficient to deal with the reality of what is needed to address the crisis facing general practice,” warned Dr Richard Vautrey, BMA GP committee chair. 

“The steady increase in patient demand coupled with hundreds of fewer full-time equivalent GPs means that practices across the country are being placed under tremendous pressure and leaving too many patients waiting too long to see their GP,” he insisted.

“Whilst there has been a modest increase in the number of salaried GPs in practices, worryingly the number of GP partners continues to show a stark decline highlighting the pressures faced by partners, who take on risks that are increasingly seen as outweighing the benefits of running their own practices,” he said.

“Punitive tax payments related to the current pensions arrangements are also having a serious impact on the retention of these GPs and must be addressed quickly by government,” he added.

The increase in the number of other healthcare professionals working in general practice and the expansion of the primary care network workforce allocated as part of the GP contract would eventually see a more sustained primary care workforce, he suggested.

But he said: “There is still much to be done to address the lack of GPs on the frontline as many continue to struggle with rising patient demand.”

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, agreed: "The reality is that we still have fewer GPs in practice than we did a year ago, despite our workload continuing to escalate.”

She continued: "A lot of hard work has gone into boosting recruitment into general practice and as a result, we have more GPs in training than ever before. But it takes at least 10 years to train a family doctor from entering medical school, and we need more GPs now.”

Retention was as important as recruitment, she pointed out: "If more GPs are leaving the profession than entering it, we are fighting a losing battle. We need to see initiatives being implemented to help retain our existing, experienced workforce and key to that will be addressing workload to make working in general practice more sustainable.”

Expanding the wider practice team would help to boost sustainability, she said, but these roles must not be seen as substitutes for GPs, especially as colleagues in vital roles, such as practice nurses, continue to struggle.

"The government promised in the GP Forward View that we would see 5,000 more GPs by 2020, as well as 5,000 more members of the wider practice team. While the latter has been exceeded, and it’s imperative we keep this momentum up, it is the number of GPs that we remain desperately short of and without resolving this we will struggle to continue providing the world-class care our patients expect and deserve.”

General practice needed to be made “a more attractive career option for those who, because of the pressures, feel disenchanted, as well as doctors who have already taken the decision to leave,” she insisted.

"NHS Improvement's interim workforce strategy needs to include comprehensive plans to further boost GP recruitment, make it easier for trained GPs to return to NHS practice, and to keep existing GPs in the profession longer – as well as initiatives to expand the multi-disciplinary team in general practice."

*General Practice Workforce, Final 31 March 2019, experimental statistics. NHS Digital, 31 May 2019.