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.
This page provides analysis on the pressures in general practice and is updated monthly with new data.
Last updated:30 August 2024
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
As of July 2024, there were 37,677 individual (headcount) fully qualified GPs working in the NHS in England. In Full Time Equivalent (FTE) terms of 37.5 hours a week, this equates to 27,662 full-time fully qualified GPs.
The overall number of GPs (including GP trainees) has seen little growth since 2015, while the number of GP partners has declined significantly during this time.
The Government has failed to deliver on promised recruitment
In a bid to reverse the stasis in GP workforce numbers, in 2019 the Government committed funding to recruit an additional 6,000 GPs by 2024. However, as of July 2024, there has only been an increase of 2,444 FTE doctors (including trainees and locums) in general practice since the end of 2019.
In July 2024 there were the equivalent of 1,702 fewer fully qualified full-time GPs than there were in September 2015 (when the current data collection method began). Numbers of fully qualified GPs have recently started to increase though – since August 2023, there has been an increase of 416 fully qualified FTE GPs.
The GP partner workforce has been shrinking since 2015 when this dataset began, with the loss of 5,713 FTE GP partners during this time. In July 2024 there were 15,942 FTE GP partners compared to 16,445 in July 2023: a total loss of 503 FTE GP partners in the last year alone. On a headcount basis, this is a loss of 522 GP partners in the last year.
With mounting pressures in general practice, these losses are set to continue further if the Government does not take appropriate action.
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 less than full-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.
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
At the same time, the number of practices is also falling. While many practices have entered into mergers, some practices have permanently closed. Factors causing this can include partner retirements, the inability to recruit staff or GP partners.
Whilst the GP workforce has been declining, the number of patients continues to increase, demonstrating the ever-mounting workload in general practice. In July 2024, another record-high of 63.42 million patients were registered with GP practices in England. As a result, the average number of patients each full-time equivalent GP is responsible for now stands at 2,293. This is an increase of 355 patients per GP, or 18%, since 2015.
Appointment levels are high
A total of 31.7 million standard (non-Covid-19 vaccination) appointments were delivered in general practice in July 2024, with an average of 1.38 million appointments being delivered per working day. This a slight decrease from the previous month (1.43 million appointments).
An average of 1.46 million appointments per day were booked in the past year (August 2023 – July 2024).
Despite this incredibly high demand, GPs are working hard to see patients: 43.6% of appointments were delivered by a GP.
In terms of access, 43.9% of appointments in July 2024 were booked to take place on the same day, compared to 44.0% in June 2024. Approximately 82.7% of appointments were booked to take place within 2 weeks in July.
Approximately two thirds (66%) of appointments were delivered face-to-face, including home visits.
A total of 371.0 million appointments (including Covid-19 vaccinations) were booked in England in the year from August 2023 to July 2024. Approximately 162.4 million appointments were delivered by GPs during that time.
During the 12 months from August 2023 to July 2024, approximately 365.5 million standard (non-Covid-19 vaccination) appointments were booked.
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