• Number of GP partners declines as salaried GPs rise
  • Latest data shows increased number of non-GP care staff
  • Number of GP trainees up 750 in 2019 compared to 2018

The number of GPs opting to work as salaried employees or locums rather than taking on partner roles is continuing to rise, according to the latest NHS workforce data.

The number of full-time equivalent GP partners has fallen 4 per cent for each of the past three years to March 2019, while the number of FTE salaried GPs has risen by at least 5 per cent in each of the same three years.

The latest data from NHS Digital reflected the continuing trend in GPs changing how they work, with growing numbers shunning the traditional GP partner model. Increasing numbers of GPs opting for salaried roles may make it easier for NHS providers to take on practices and could impact on the development of new primary care networks.

Meanwhile, workload and worries about pensions are increasingly being cited as reasons for GP partners stepping down.

Expanded workforce

The data also showed an increase in nurses and other staff providing patient care – such as healthcare assistants – in primary care, up from 28,500 in March 2018 to 29,500 this year.

This rise will likely continue as the additional workforce promised in the new five-year GP contract moves into post.

Nearly £900m has been set aside by NHS England to part-fund the salaries of additional clinicians for PCNs.

The first year of the five-year GP contract also makes funding available to pay for salaries of new social prescribing link workers, and part of salaries of additional clinical pharmacists. Subsequent years will bring part-funding for physician associates, physiotherapists, and community paramedics so they can join the multidisciplinary teams working across PCNs.

According to Nigel Watson, chief executive of Wessex Local Medical Committees, the additional workforce will help alleviate GP workload. Dr Watson is also chair of the Department of Health and Social Care’s GP partnership review, which made several recommendations for how to reverse the trend in declining GP partners.

“To address the workload, we need an expanded workforce and that’s where I think PCNs are key in terms of being a delivery unit which supports practices,” he told HSJ.

He added: “Being part of the wider system is also important, where you get greater integration with community and mental health [services].”

But he stressed it would take time for GPs to feel the benefit of the expanded workforce or the measures set out in the partnership review.

Retention and recruitment

The data also showed there are 750 more FTE GP trainees compared to March 2018, an increase of 14 per cent. The key will be to move them into permanent roles rather than seeing them work as locums, Dr Watson said.

Helen Stokes-Lampard, president of the Royal College of GPs, added that retention is just as important as recruitment

“A lot of hard work has gone into boosting recruitment into general practice and as a result, we have more GPs in training than ever before,” she said. “[However], if more GPs are leaving the profession than entering it, we are fighting a losing battle.

“We need to see initiatives being implemented to help retain our existing experienced workforce and key to that will be addressing workload to make working in general practice more sustainable.”

New data revelaed by Pulse magazine today showed the number of GP practices closing is rising. A total of 583 have closed in the last six years and 138 surgeries shut down last year, compared with just 18 in 2013.

Richard Vautrey, BMA GP committee chair, said: “Whilst there has been a modest increase in the number of salaried GPs in practices, worryingly the number of GP partners continues to show a stark decline highlighting the pressures faced by partners, who take on risks that are increasingly seen as outweighing the benefits of running their own practices.

“Punitive tax payments related to the current pensions arrangements are also having a serious impact on the retention of these GPs and must be addressed quickly by government.”