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: 1 November 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 September 2024, there were 38,124 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 27,966 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.
Successive Governments have 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 September 2024, there has only been an increase of 3,902 FTE doctors (including trainees and locums) in general practice since the end of 2019.
In September 2024 there were the equivalent of 1,399 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 – there has been an increase of 663 fully qualified FTE GPs in the last 12 months.
The GP partner workforce has been shrinking since 2015 when this dataset began, with the loss of 5,758 FTE GP partners during this time. In September 2024 there were 15,897 FTE GP partners compared to 16,342 in September 2023: a total loss of 445 FTE GP partners in the last year alone. On a headcount basis, this is a loss of 433 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. As of September 2024, 1,367 practices have closed since 2015. 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 September 2024, another record-high of 63.57 million patients were registered with GP practices in England, an increase of 6.7 million since 2015. As a result, the average number of patients each full-time equivalent GP is responsible for now stands at 2,273. This is an increase of 335 patients per GP (over 17%) since 2015.
Appointment levels are high
Almost 30 million standard (non-Covid-19 vaccination) appointments were delivered in general practice in September 2024, with an average of 1.43 million appointments being delivered per working day. This a significant increase from the previous month (1.32 million appointments per working day).
Over the 12 months from October 2023 to September 2024, approximately 361.8 million standard appointments were booked.
Despite this incredibly high demand, GPs are working hard to see patients: 44% of appointments were delivered by a GP in September 2024.
In terms of access, 43% of appointments in September were booked to take place on the same day, compared to 45% in August. Approximately 82% of appointments were booked to take place within 2 weeks in September.
Two thirds (66%) of appointments were delivered face-to-face, including home visits.
A total of 365.7 million appointments (including Covid-19 vaccinations) were booked in England in the year from October 2023 to September 2024. Approximately 161.2 million appointments were delivered by GPs during that time.
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