The number of GPs in the UK is falling in a sustained way for the first time in more than 50 years, according to new research.
Analysis by the Nuffield Trust on behalf of the BBC shows that there are now 60 GPs per 100,000 people in the UK – which is down from 64 just five years ago and means that the average doctor now has 125 more patients to look after than they did in 2014.
If the overall total of GPs had actually kept pace with population growth since 2014 then there would have needed to have been 3,400 more people in the profession.
This relative-to-population fall comes despite a rise of about half a million GP appointments in November 2018 compared to the previous November.
Regional figures also show a big disparity in different parts of the UK, with the East of England and North West London having just 54 GPs per 100,000 people compared to 76 in Scotland.
‘We need to keep skilled GPs in the profession’
MDS CEO Rohan Simon said: “This analysis shows it’s vitally important that we look after our existing GPs and keep skilled people in the profession. Medical Defense Society was established to stand up for GPs and help to ease the burden of indemnity costs, one of the factors that was contributing to GPs leaving their roles.
“This continues to be our mission as we offer the continued support and advice that GPs need for all of the important work they do that falls outside of the state backed indemnity scheme.
“We hope that more can be done to look after GPs and ensure that this fall reverses.”
Nuffield Trust director of strategy Helen Buckingham said that within the next five years the UK could be 7,000 GPs short. She pointed to a number of factors causing the drop in numbers including:
- the after-effect of a decrease in training places
- the number of GPs who have taken early retirement
- the trend of people leaving after they’ve qualified without going on to work as an NHS GP
The BBC noted that the NHS had previously been struggling to attract junior doctors to become GPs, with as many as one in ten training places empty.
That issue has eased now, and the 3,500 trainee posts taken up last year is up 800 on 2014. However, with it taking three years to train a junior doctor to become a GP, that will take a while to filter through.
‘Disheartening but not surprising’
Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: “These figures are disheartening but will be unsurprising for GPs – and their patients – across the country who are feeling the impact of relentless workforce pressures in general practice on a daily basis.
“There is some excellent work ongoing to boost recruitment into general practice and as a result we have more GPs in training that ever before. But GPs cannot be trained overnight, and whilst we wait for the next generation of family doctors to enter the workforce, existing GPs and our teams are struggling to manage escalating workloads without enough time or the resources to deal with them.
“Demand for GP services is escalating both in terms of volume and complexity – and when this is compounded by falling GP numbers, it creates a perfect storm that is leading to GPs becoming stressed and burning out, and in many cases leaving NHS general practice far earlier than they might otherwise have done.
“More must be done to keep our hard-working, experienced GPs in the profession for longer – not only are they vital to delivering vital care to over a million patients a day, but they have a huge amount of wisdom to impart to new colleagues.”
Measures needed to help GPs
GP numbers were falling in the late 1960s but then grew continuously for about four decades before peaking at 66.5 in 2009. Numbers have now fallen for four consecutive years.
Professor Stokes-Lampard said the situation for GPs is not all negative, but more must be done to address the fall in GP numbers.
She added: “We are optimistic about the future of general practice: the financial commitment to primary and community care in the NHS long-term plan in England; the new five-year GP contract which promises that money will get to the front line; and pledges to ensure greater investment in technology are all part of a jigsaw that should help keep the NHS sustainable for the future. But GP numbers, which as this research shows are still falling, cannot be ignored.
“We need see more measures implemented to genuinely tackle soaring workload as a matter of urgency and efforts redoubled to cut red tape that diverts time away from patients, and we need to make the working environment in general practice supportive and sustainable, so that family doctors aren’t forced out of the profession. This would not just be in the best interests of GPs, but the NHS as a whole, and most importantly, our patients.”
MDS CEO Rohan Simon said: “MDS was created by GPs so we understand the pressure felt by our members – and what’s needed to look after their needs. We’re keen to ensure our GPs are happy and would welcome contact from anyone who needs further advice about coping with their workload.”
If you’re a GP and would welcome the services of an indemnity provider that was set up by GPs purely to look after GPs then get in touch, we’d love to hear from you.
GPs can save up to 20% off the cost of their indemnity thanks to a new referral scheme.
Medical Defense Society, the only MDO designed and established by GPs for GPs, is looking to reward members who can help to attract new members.
If any MDS member refers a new GP then both parties – the new and existing member – will receive 5% discount off their membership costs.
Each MDS member is able to refer up to four new GPs as part of the referral scheme, meaning that they can save up to 20% in total.
Rewarding our members
MDS CEO Rohan Simon said: “We’re extremely grateful to our existing members for the role they have played in helping to establish our business. From the very start, we wanted to offer a membership service that gave a fairer deal for GPs and we’ve been able to deliver on that promise thanks to the support from the GPs who put their faith and trust in us.
“We’re always delighted to hear your positive feedback and we know that your personal recommendations play a powerful role in persuading others to join the MDS family.
“That’s why we were keen to launch this referral scheme and reward you for playing your part.
“We’re confident that we can impress GPs with our dedicated indemnity service and that, together, we can continue to grow.”
Many GPs have been considering a review of their indemnity in light of the new state-backed scheme.
If you want to find out more about what MDS’ cover includes or wish to discuss the referral scheme in greater detail, contact us today.
The rules surrounding private healthcare services delivered by GPs have now changed, amid fears of a ‘blurring’ of the lines between NHS and non-NHS work.
As part of widespread changes to the GP contract, NHS England has decided to ban the advertising and hosting of private GP services from April 1.
The 2019/20 GP contract states: “To safeguard the model of comprehensive NHS primary medical care, from 2019 it will no longer be possible for any GP provider either directly or via proxy to advertise or host private paid-for GP services that fall within the scope of NHS funded primary medical services.
“NHS England will consult in 2019 on expanding this ban on private GP services to other providers of mainly NHS services.”
What the changes mean for GPs
It’s important to recognise that this doesn’t bar GPs from all non-NHS work. Indeed, a full range of services – from medical reports for insurance to physiotherapy and signing passports will still be a natural part of life for a great many GPs.
However, this stops practices from being able to charge patients for services that are free under the NHS or to get quicker access to their GP. It’s about making it completely clear as to what is available under the NHS and what isn’t – and therefore incurs a charge to the user.
There has been a rise in private treatments offered by GPs in recent years. The Guardian reported that demand for this has been growing after cuts and cost savings instigated by the NHS.
Private providers have offered GP access
Online private GP services have sprung up to offer people out of hours access to a doctor over the internet.
These services are reportedly particularly popular among millennials, with many young people preferring to pay than wait for an appointment. Practice Business noted that three quarters of patients in a network of private clinics were aged between 20 and 39.
It quoted Dan Faber, founder, DocTap, as saying: “Patients are out of patience and they are no longer prepared to wait for or travel to an NHS appointment. They want to see a doctor on their terms and they want to choose the doctor that they want to see. It is clear that the existing NHS GP model is outdated and is unable to service the new millennial generation who want convenience.”
Confidence in the GP service
The NHS England and the British Medical Association in a bid to ‘maintain patient confidence’ in the GP service and set a clear distinction between what is and isn’t allowed.
Dr Richard Vautrey, chair of the British Medical Association’s GP committee, said: “While the BMA represents the breadth of the medical profession, including private practitioners, we have been concerned at the increasing blurring in recent years between NHS and private GP services offered to patients, particularly with the opportunities digital technology is providing.
“This change will provide clarity for patients about what treatment is available on the NHS and what they have the option of paying for privately.
“Both NHS England and the BMA want clarity for patients about what are free NHS GP services and what are not, and we are determined to maintain patient confidence in the integrity of general practice.”
GPs need indemnity for all of their work
The new rules offer a welcome clarification on the dividing lines between NHS and private work. This debate also goes to emphasise that there is much non-NHS work that naturally falls at the feet of GPs – work that will continue unchanged.
This is important to bear in mind when it comes to the new state-backed indemnity scheme, which only covers cases of clinical negligence that come from NHS activities within the scope of the scheme. That means that any non-NHS work is not covered by the Government’s scheme and this is one of the many reasons why GPs will still need to maintain their membership with an MDO.