Pressures in general practice data analysis

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.

NHS pressures waiting list

GP practices across the country are experiencing significant and growing strain with declining GP numbers, rising demand, struggles to recruit and retain staff and knock-on effects for patients.

They have been at the forefront of the NHS's response to the COVID-19 outbreak, delivering vaccines whilst maintaining non-COVID care for patients throughout.

This page provides analysis on the pressures in general practice and is updated monthly with new data.

Last updated: April 2022

FTE / headcount

NHS Digital publishes workforce data as both headcount and FTE (full time equivalent).

Headcount refers to the number of individual doctors, while FTE is the proportion of full-time contracted hours that the post holder is contracted to work. 1 FTE would indicate they work a full set of hours, 0.5 that they worked half time.

As FTE reflects the true number of clinical hours the NHS has at its disposal, we usually find FTE to be more meaningful than headcount. However, we also use headcount where appropriate. This page uses both headcount and FTE and will be clearly stated throughout.

Full-time here is taken to be 37.5 hours in accordance with the standard definition of 1 FTE used by NHS Digital. This calculation is for illustrative purposes only, as we recognise that in practice some employed doctor contracts can be 40 hours.

England has a shortage of GPs

GP growth has stagnated for many years

The overall number of GPs has seen little growth since 2015, with the number of GP partners declining significantly over that time.

In February 2020, in a bid to reverse the stasis in GP workforce numbers, the Government announced a drive to recruit an additional 6,000 GPs by 2024. 

The Government has failed to deliver on promised recruitment

Yet despite these promises, as of March 2022 (latest data) we actually now have the equivalent of 1,595 fewer fully qualified full-time GPs compared to 2015.

In the year between March 2021 and March 2022, the NHS lost 330 GP partners and 356 salaried and locum GPs. This means that the number of fully qualified GPs by headcount decreased by 686 net in just over one year.

With over one in 10 (16%) of respondents to a BMA survey telling us they plan to leave the NHS altogether after the pandemic, this figure is expected to rise.

In FTE terms of 37.5 hours per week, this equates to a loss of the equivalent of 369 full time fully qualified GPs in the year between March 2021 and March 2022.

GPs are changing their working patterns

Since 2017, the number of GPs working full time hours or more in GP practice-based settings has been steadily decreasing.

At the same time, the number of GPs choosing to work some degree of part-time has been climbing. This is likely because doctors are, understandably, moving towards working patterns that allow them to better control their hours and workload in order to reduce stress, ill-health and burnout and to improve work-life balance.

Although these GPs may be working less than one FTE on paper, in reality 'part time' as a GP very often means working a number of additional unpaid hours just to get through the large numbers of appointments and essential patient follow-up (administrative) work.

Recent survey responses from BMA members suggest this trend is likely to continue (September 2021; just over 2,050 overall respondents) with half of respondents saying they plan to work fewer hours after the pandemic.

We are also seeing more than two in five (42%) planning to work more flexibly and from home more.

Fewer doctors are looking after greater numbers of patients

Despite there being 1,595 fewer fully qualified FTE GPs today than there were in 2015, each practice has on average 2,222 more patients than in 2015.

There are now just 0.45 fully qualified GPs per 1,000 patients in England – down from 0.52 in 2015. For the GPs that remain, this means increasing numbers of patients to take care of. The average number of patients each GP is responsible for has increased by around 300 – or 16% - since 2015.

At the same time, the number of practices is also falling. While many practices have entered into mergers, practices can also be closed for other reasons. For example, inability to recruit staff or GP partners, no longer viable, partner retirements or CQC closures due to under resourcing.

 

Appointment levels are high

NHS Digital’s appointments in general practice dataset is classified as ‘experimental statistics’ due to variations in quality and practice coverage. This means data may be incomplete or missing. The following should, therefore, be interpreted with caution and seen as a guide, not a complete or exhaustive indicator of activity.

General practice appointment bookings reached record highs over the winter of 2021 with GPs seeing more patients than ever.

There has been a steep increase in the number of appointments booked this month. The March 2022 total of 30.1 million appointments is over 5.4 million (+22%) more than the levels of March 2020.

The ratio of F2F (face-to-face) versus remote appointments has shifted with the waves of the pandemic, but the majority of appointments have always been delivered in person. Currently, nearly two thirds of appointments are F2F.

 

What the BMA is calling for

Increasing and retaining the workforce

The BMA is calling for long term investment in increasing the NHS workforce. This must be accompanied by a workforce strategy to ensure that the appropriate number of future staff are being recruited and trained. There must be immediate implementation of measures to retain existing staff. See our NHS workforce data analysis for more detail.

Support to clear the backlog

The BMA is calling on the Government to urgently and properly invest in general practice staff, services and premises and to remove unnecessary targets and bureaucracy.

Protecting GPs

General practice has faced media scapegoating for simply implementing Government and NHS policies designed to keep patients safe.

The BMA is calling for the Government to provide consistent public statements of support for GPs and deliver on its commitment to work with the BMA and other healthcare organisations on a national campaign to stop abuse of NHS staff.

We also call on the Government to deliver on its promise of increased sentencing for those who assault emergency workers to two years, and introduce heavier punishments for verbal abuse against NHS staff.

See our support your surgery campaign for more detail.