Pressures in general practice

We monitor data on GP workforce, working patterns and appointment numbers to help build a picture of the level of strain GP practices in England are under.

Location: England
Audience: GPs Practice managers
Updated: Thursday 15 July 2021
NHS Structure Article Illustration

The NHS is currently experiencing some of the most severe pressures in its 70-year history.

GP surgeries across the country are experiencing significant and growing strain with rising demand, practices struggling to recruit staff, and patients having to wait longer for appointments.

Alongside these long term trends, in recent months GP practices have been at the forefront of the NHS’s response to the COVID-19 outbreak.

 

GP workforce data charts

Our analysis

The overall number of FTE (full-time equivalent) GPs has seen little growth since 2015, with the number of GP partners significantly reducing in that time.

In February 2020, to combat the stasis in GP workforce numbers, the Government announced a drive to recruit an additional 6000 GPs by 2024. That’s 1200-1500 extra doctors in general practice per financial year by the end of 2024.

Slight increase in GP numbers

Between March 2020 to March 2021, the number of older, more experienced GP partners reduced by 546 doctors. Factoring in this decrease, the number of qualified GPs increased by 1541 (salaried and locum GPs only) in that time.

Looking at this on a FTE basis (37.5 hours per week), the number of fully qualified FTE GPs only increased by 110.7 (to 28,096) over the past year.

GP working patterns

Since 2017 the number of GPs working full time hours or more has been steadily decreasing. The number of GPs choosing to work some degree of part-time has been climbing.

The medical workforce trend appears to show that doctors are moving towards working patterns that let them control their hours and workload better. This is most likely to avoid stress, ill-health and burnout.

This is supported by recent survey responses from BMA members (April 2021; 4230 overall respondents):

  • almost 50% of respondents said they are currently suffering from depression, anxiety, stress, burnout, emotional distress or another mental health condition
  • of these, 40% are suffering 'worse than before the start of the pandemic'
  • just under 40% said their health and wellbeing is 'slightly' or 'much worse' now compared to wave one
  • just under 60% say their level of exhaustion or fatigue is 'higher than normal', whilst over 40% said non-COVID patient demand 'is now considerably higher than pre-pandemic'
  • almost 30% have undertaken additional unpaid hours, whilst over 40% have felt 'slight' or 'significant' pressure to work additional hours from their employer.

GP to patient ratio

The number of patients per practice is 22% higher than it was in 2015, but the GP workforce has not grown with this demand.

As a result of this stasis, there are now just 0.46 fully qualified GPs per 1000 patients in England - down from 0.52 in 2015.

This is significantly below the average number of physicians per 1000 patients in comparable nations (3.5).

Appointments and prescribing

Regular appointment numbers are more or less steady from April 2021 but down slightly (by approx. 1.2 million) compared to May 2019.

Covid vaccination appointments delivered by general practice add an additional 8.6 million to that figure.

The number of Covid vaccinations delivered by practices is still steadily rising, reaching 7.9 million in May 2021.

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