A new study reveals that the number of full-time equivalent (FTE) GPs in England has dropped by nearly 3% since 2015, and the primary reason for this decline? Male GPs are cutting back on the number of hours they work.
The study, carried out by researchers at the University of Manchester and funded by the Health Foundation, looked at GP practice data from 2015 to 2022. It explored the relationship between the availability of GPs (the "supply") and the demand at the practice level. They found that overall, the supply of GPs reduced by 2.7%, mainly because many GPs were choosing to work fewer hours. This decrease in contracted hours has led to a significant rise in the number of patients each full-time GP must look after.
The drop in GP supply has resulted in a steep increase in the number of patients per FTE GP. In 2015, the average number of fully qualified FTEs per GP was 0.8, but by 2022, this number had fallen to 0.69. Interestingly, this reduction was primarily driven by male GPs rather than female GPs.
During this period, the number of patients registered per FTE GP grew by 9%. Even more concerning was the sharp 32% increase in the number of patients with chronic conditions, according to data from the Quality and Outcomes Framework (QOF) disease register.
In 2022, it was estimated that there were about 2,478 patients for every FTE GP, compared to 2,271 in 2015. The study suggests that this increase in patients and chronic conditions, coupled with the reduction in hours worked by GPs, is putting significant pressure on primary care services.
The research also highlighted some worrying trends related to deprivation. GP practices in the most deprived areas had 17% more patients and 19% more chronic conditions per FTE GP than those in the least deprived areas. This shows that the areas with the greatest need for healthcare are also the ones with fewer resources to meet that demand.
The study used the number of patients aged 65 and over as one way to measure demand. Between 2015 and 2022, the number of older patients increased by 12% across England. However, in deprived areas, the number of older patients per FTE GP fell by 25%. This means that while there were more older patients in the least deprived areas, those in more deprived areas were receiving less care.
The researchers also found that certain regions of England, particularly those outside of London, had higher numbers of chronic conditions per FTE GP. London stood out as an exception, with lower levels of demand.
The most striking finding of the study was that the reduction in GP supply was mainly driven by male GPs reducing their working hours. While the study did not fully explain why this was happening, lead author Dr. Rosa Parisi noted that the trend could be linked to early retirements, high turnover rates, and low retention of GPs. She also pointed out that there aren’t enough newly trained GPs joining the workforce, and there has been a lack of recruitment from overseas.
While both male and female GPs have reduced their hours, the reduction was most pronounced among male GPs. In 2015, the median FTE for male GPs was 0.99, but by 2022, this had dropped to 0.85. For female GPs, the FTE number stayed relatively stable, decreasing only slightly from 0.67 to 0.66.
The researchers suggest that policies should be put in place to encourage male GPs to work more hours, as their reduced working time has been the biggest contributor to the overall drop in GP supply. However, they also acknowledge that this issue is part of a bigger, systemic problem. GPs are under immense pressure in their day-to-day work, and many are likely unwilling or unable to increase their hours because of the intense demands of primary care.
In addition to policies aimed at increasing GP working hours, the study also calls on the Government to reduce GP workloads and create incentives for GPs to work in and stay in deprived areas. Without these changes, the current trends are likely to continue, making it even harder for patients to access the care they need.
The study also draws attention to the fact that Government promises to increase GP numbers have not been met. In 2015, the Government promised an additional 5,000 GPs by 2020, and in 2019, they pledged 6,000 more GPs by 2024. While the headcount of GPs did rise by 5.9% between 2015 and 2022, this increase falls far short of the promised numbers. In fact, during this period, only 2,154 additional GPs were added to the workforce, far below the target.
Senior author Professor Evan Kontopantelis explained that this failure to deliver on promised GP numbers, combined with changes in working patterns, has made the challenges facing primary care even more severe.
The study also raises questions about the current definition of full-time work for GPs. Some researchers argue that the British Medical Association’s (BMA) definition of full-time working hours is outdated. They suggest that full-time work should be redefined as six sessions per week to reflect the actual length of current GP sessions.
Please share by clicking this button!
Visit our site and see all other available articles!