NEWS: GP numbers fall, workload grows

As reported by GP Online, new data reveals a significant decline in GP partners and overall GP numbers in England, despite increasing patient appointments, sparking financial and workforce concerns

The decline in GPs in partnership roles over the course of the multi-year contract is even more stark. FTE GP partners in England slumped to 16,143 in March 2024 – down 2,887 from 19,030 in March 2019, a decline of 15.2%.

Despite the fall in fully-qualified FTE GPs over the course of the five-year contract, fully-qualified FTE GP numbers have grown slightly over the past 12 months, the figures show. There were 268 more fully-qualified FTE GPs at the end of March this year than at the same point in 2019.

GP workforce

GP partners, however, continued to fall over the past year – dropping by 456, or 2.7%, in the year to 31 March.

Meanwhile, the latest data on appointments in general practice show that practices delivered 13.6% more appointments in March this year than in March 2019 despite the reduction in qualified GPs. GP practices delivered an estimated total of just under 29.9m appointments this March – up from 26.3m in March 2019.

The figures suggest that the five-year contract – billed at the time of its announcement as paving the way to ‘rebuild general practice’ – has failed to deliver on that score.

Alongside the decline in the GP workforce since 2019, the financial position of GP practices has been severely eroded under the multi-year contract, doctors’ leaders say. BMA England GP committee negotiators told the government in talks over the 2024/25 GP contract that the profession needed an 8.7% uplift in funding just to return practices to the financial position they were in at the start of the multi-year contract, after fixed annual uplifts failed to keep pace with rising costs.

Contract dispute

The GP committee has told health service officials that the profession is now ‘in dispute’ with NHS England over the contract ultimately imposed on the profession for the current financial year, which offered a 1.9% uplift that GP leaders say amounts to the ‘constructive dismissal’ of general practice.

Liverpool LMC chair Dr Rob Barnett told GPonline: ‘The five-year contract has completely failed to rebuild general practice. It was sold on the basis that it was putting in more resources to general practice, but the investment was in non-doctors and a workforce that actually hasn’t done anything to improve patient care or to reduce GP workload.

‘The government has put more money in, but it put that money in the wrong place. That in itself has had an effect in driving the reduction in GPs – because GPs don’t want to be left to take responsibility for a failing service. That is why we have seen an increase in practice closures and a loss of partners.’

The Liverpool LMC chair said changes to general practice were pushing it towards becoming an ‘illusion of a service, as opposed to a real service’ – and warned the change was ‘very disturbing’.

Practice closures

GP leaders have warned that the 2024/25 GP contract threatens a ‘slew of practice closures’ – and even before the latest contract an LMC report warned that more than half of practices needed urgent support to avoid closure within the near future.

GPs have warned that underfunding of core general practice services alongside ringfencing of funding for additional roles staff is driving practices towards a ‘GP-lite’ model, with fewer GPs facing rising workload as they deliver more appointments themselves and supervise growing numbers of other staff.

GPonline has reported that many GPs are struggling to find work because practices can’t afford to recruit them – with one qualified GP deciding to work for Uber because they were unable to find a job in general practice, and others forced to turn to foodbanks.

Figures from BMA and GMC polling suggest the workforce crisis could deepen over coming years – with a GMC survey showing more than one in five GPs are likely to move abroad in the next year and BMA data showing less than two in five current GP registrars plan to work in NHS general practice when they qualify.