A BMA survey has revealed that four out of five locum GPs in England (84%) cannot find work, despite patients waiting weeks for appointments. An overwhelming number of those who responded to the survey said they could not find suitable positions and because of that, more than 50% are expecting to make changes to their work or career plans in the next year.
More worryingly, many (33%) have already made definite plans to change work or career paths, and the BMA fears patient access will worsen in England as one-third of respondents (31%) who are planning for change say the lack of suitable shifts is forcing them to leave the NHS entirely.
Last year, BMA warned the government that the current ARRS model, which only funds non-GP roles, would exacerbate the GP employment crisis. 71% of respondents blame the ARRS for GP unemployment.
A locum GP from Dorset said: “I sacrificed my life for the NHS and now I can’t even find a job because GPs are being replaced by cheaper staff. I’ve explored countless options within the NHS to no avail so I’m taking up GCSE tutoring to make ends meet. I’m a single mum with a child who has special needs and I thought if I studied hard, worked hard and dedicated myself to the NHS then I’d be able to provide for myself and my children. But after nearly 30 years of service, I’ve been driven out of the NHS by a government scheme that blocks general practice from employing general practitioners – it’s maddening.
“I’m compassionate, caring, and very good at my job, but my skills are being wasted as I spend most days watching daytime TV. There’s an immense satisfaction that comes from caring for patients, and while I do get some fulfilment from tutoring, I didn’t need to waste my time at medical school, sit countless stressful exams, and rack up thousands of pounds of debt to become a tutor.”
A GP from London said: “Being a locum GP used to be a stable and interesting job, but almost overnight, the work dried up. I couldn’t find consistent work and began to worry about the future, so I started applying for salaried roles. While I prefer the variety of locum work, I have a young family and a mortgage to pay, so I had to take action. After years of studying and a wealth of experience, I thought finding a salaried role would be easy. However, I ended up applying for nearly 30 positions, received only three interviews, and fortunately secured one job. Honestly, I feel lucky to have found a job, as I know many have not. Who would have thought that becoming a doctor would lead to job insecurity and worries about meeting mortgage repayments?
“The problem with replacing GPs with cheaper alternatives is that what might appear to be a routine condition, particularly in children, may actually turn out to be a serious illness. For example, a patient might come into a practice complaining of muscular pain, but only a trained GP can swiftly differentiate between muscular pain and deep vein thrombosis. This is why patients deserve to be seen by GPs.”
83% of respondents who can find work do not feel they have enough time in sessions to provide patients with safe and thorough care, with 31% reporting having to work beyond their agreed session contracts to meet these standards. Survey respondents also report working, on average, a full day less per week now than they did in 2022.
Dr Mark Steggles, BMA sessional GP committee chair, said: “These shocking results reinforce what many locum GPs are telling us – they cannot get any, or enough work. As well as the stress and worry that causes them - when combined with the lack of NHS salaried and partnership opportunities - it leaves us in the ridiculous situation where so many patients are being denied the chance to see a GP, even though we have GPs wanting to work and care for them.
“On the one hand, we have thousands of GPs in England desperate to work more, but being driven into careers outside the NHS. On the other hand, patients in pain, needing care, are waiting record-breaking periods of time to see a GP. It's difficult to comprehend how the NHS - a health service once world-renowned - has reached this point where thousands of highly-skilled doctors are unable to find suitable work within it and patients are suffering as a result.”
Professor Philip Banfield, chair of BMA council, said: “How is it possible to have thousands of patients needing treatment and GPs available to give that care, but prevented from doing so by a system unable to pay them? To have highly-qualified doctors turning to other jobs to earn a wage whilst GP practices cannot meet the demands placed on them and patients waiting weeks for an appointment, shows what a fiasco the NHS has been turned into. It is clear we have a government which has not only watched, but aided and abetted the decline of general practice and with it, the morale and goodwill of our GPs, especially in England. GPs are hugely underappreciated - there is no substitute for their skills and experience. NHS England and ministers should be absolutely ashamed of the mess that is primarily of their creation and now be doing everything in their power to try to restore and rebuild the cornerstone of efficient and effective healthcare – the family doctor.”
Dr Katie Bramall-Stainer, chair of the BMA’s GP committee for England, said: “We are in a ridiculous situation where GP practices cannot use government funding to hire GPs. We have made it clear to the government that this needs to change so we can have more GPs working in local practices. In last year’s BMA GP Practice Finance survey3, more than half of practices (54%) reported cashflow challenges that were affecting the day to day running and meant that practices were going without locum cover and partners were trying to cover for each other, to care for their patients, because of the lack of GPs.
“We’re hearing lots of pre-election promises about increasing GP numbers, but the first challenge for the next government will be to find a way to keep the GPs we already have in the NHS. To run a bath, you first must put in the plug; this is basic workforce planning.”
Dr Clare Bannon, GP practice partner and BMA England’s GP committee lead for clinical and interface policy, said: “The Government has ring-fenced the funds that practices use to hire staff and blocked us from employing GPs. Patients deserve to be seen by doctors. GPs have the education and skills to differentiate between routine conditions and serious illnesses, making access to a GP potentially a matter of life and death. Understandably, patients are frustrated and concerned about their lack of access to family doctors. At the same time, GPs are desperate for work, and practices are unable to hire them. This situation is truly a destructive and ridiculous paradox.”
Notes to editors
- 1,852 locum GPs in England responded to this BMA survey
- Snapshot of released BMA survey questions for locum GPs in England
- GP patients likely to suffer unless Government improves inadequate GP contract offer, warns BMA
- Of the 84% of respondents who want to work more sessions, they report wanting to work an additional 3.6 sessions on average – equivalent to nearly 2 more days’ work a week per person.
- Respondents report that in 2022 on average they worked 5.8 sessions per week – nearly 3 days per week - which is 2.8 sessions more than they currently work – equivalent to more than a full additional day a week per person.
- We asked about job availability and job suitability compared to two years ago. 91% of respondents told us work availability had decreased and 84% told us suitability had reduced even where jobs are available. The most common issues for sessions being unsuitable were insufficient remuneration, or available work being too far away.
- Only 1% said work availability had increased and 3% said it had stayed the same – 6% were not sure. Regarding suitability, only 1% said suitability had increased and 8% said it had stayed the same – 8% were not sure.
- The BMA calculates that core funding to the GP contract in England (GMS) has fallen by £659m (or 6.6%) in real-terms (CPI) since 2018/19. Separate ARRS staff funding cannot be spent on GPs.
The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.