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: 4 April 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 February 2024, there were 37,252 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 27,502 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 February 2020 the Government committed funding to recruit an additional 6,000 GPs by 2024. However, as of February 2024, there has only been an increase of 2,787 FTE doctors (including trainees and locums) in general practice since the end of 2019.
Despite an increase in the overall number of doctors working in General Practice, in February 2024 there were the equivalent of 1,862 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 started to increase recently though – in February 2024, there were 225 more fully qualified GPs than there were in February 2023.
The GP partner workforce has been shrinking since 2015 when this dataset began, with the loss of 5,496 FTE GP partners during this time. In February 2024 there were 16,159 FTE GP partners compared to 16,563 in February 2023: a total loss of 405 FTE GP partners in the last year alone. On a headcount basis, this is a loss of 438 GP partners.
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, 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.
Whilst the GP workforce is declining, the number of patients is increasing. In February 2024, another record-high of 63.20 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 2,298.
This is an increase of 360 patients per GP, or 19%, since 2015, demonstrating the ever-mounting workload in general practice.
Appointment levels are high
A total of 30.5 million standard (non-Covid-19 vaccination) appointments were delivered in general practice in February 2024, with an average of 1.45 million appointments being delivered per working day. This is lower than the average of 1.48 million appointments per working day the previous month.
An average of 1.40 million appointments per day were booked in the past year (March 2023 – February 2024).
The number of Covid-19 vaccination appointments decreased significantly from about 11,700 in January 2024 to approximately 140 in February 2024.
Despite this incredibly high demand, GPs are working hard to see patients: 45% of appointments were delivered by a GP.
In terms of access, 44% of appointments in February 2024 were booked to take place on the same day: a slight decrease from the previous month (45% in January 2024). Approximately 84% of appointments were booked to take place within 2 weeks in February – similar to the previous month.
Two thirds (67%) of appointments were delivered face-to-face.
During the 12 months from March 2023 to February 2024, approximately 354.8 million standard (non-Covid-19 vaccination) appointments were booked. When comparing to pre-pandemic levels, this is 42.8 million more appointments than between March 2019 and February 2020.
A total of 361.9 million appointments (including Covid-19 vaccinations) were booked in England in the year from March 2023 to February 2024. Approximately 161.1 million appointments were delivered by GPs during that time.
What the BMA is calling for
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.
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.
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.
