Hot Topic: GP Shortages and Challenges
Alongside staff shortages and pressures in secondary care, it’s also vital to be aware of the current issues around staffing in general practice. GPs help around 50 million people in Britain each year – the vast majority of the population – and carry out 370 million consultations in a given year.
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What do the numbers say about GP shortages?
In 2019, the Conservative party promised to increase the UK’s GP numbers by 6,000 by 2024. However, in reality the number of GPs working full time in England has fallen, according to the NHS’s latest figures. Let’s look at those figures in more detail:
- The number of fully qualified GPs who work full time has fallen by 5% between September 2015 and 2021 – meanwhile, the overall population is 4% larger and their health problems are getting ever-more complicated.
- In April 2022, there were 45 fully qualified FTE GPs per 100,000 patients. In contrast, when records began in September 2015, there were 52. On average therefore, a GP now looks after more than 2056 patients – 10% more than they did in 2015.
- 42% of GPs have stated that they are planning to quit the profession in the next five years.
- 80% of GPs have stated that they expect working in general practice to get worse over the next few years. Meanwhile, only 6% expect it to get better.
- Over the past year, the NHS has lost 402 GP partners, and 244 salaried or locum GPs. This makes a net loss of 646 GPs since January 2022. This amounts to an equivalent of 470 full-time GPs (remember that not all would have worked full time) in the past year alone.
An additional issue is that since 2017, the number of GPs choosing to work full time in practice has been decreasing steadily. Meanwhile, the number of GPs choosing to work part-time has risen, as doctors decide to prioritise their own work-life balance and avoid burnout. However, whilst these GPs may be working less than full time on paper, they may in fact still be working a number of unpaid hours on administrative tasks, just to allow them to then carry out their paid work. It appears that this trend is likely to continue to develop, with half of BMA respondents in a survey stating that they plan to work less after the pandemic. Additionally, more than two in five (42%) GPs are planning to work more flexibly and from home more.
Meanwhile, appointment bookings reached their highest ever level in the winter of 2021, and the number of standard appointments has remained high since, with 26.8 million appointments booked in January 2023– a 9% increase from the previous month. Looking at access to GPs, 45.3% of appointments in January 2023 were booked to take place on the same day. 85.4% of appointments were booked to take place within 2 weeks. In terms of location, 69.4% of appointments were booked to take place face-to-face in January 2023, an increase from the previous month. It’s therefore clear that GPs are working hard, despite the issues that they face.
It’s worth noting that the figure of 370 million consultations mentioned in the introduction is also an 18.5% increase when compared to 2019. Additionally, the number of clinical administration tasks delivered by GPs in England rose by 28% over the same time period, up to 107 million in 2021.
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What do GPs want?
GPs have the following demands:
• A plan to achieve and go beyond the targets of 6000 extra full time equivalent GPs and 26,000 additional staff in non-GP roles. This should include measures to:
– Make the funding rules more flexible so practices are able to hire the staff they need, including nurses, and invest in supporting supervision and training to better integrate teams.
– Expand the number of GP training places by at least 10% year on year.
– A greater proportion of NHS budgets allocated to general practice to return funding to 11% of total health spend.
– An easier process for international doctors who complete their training as NHS GPs to apply for long-term visas to stay and work in the UK.