Over 500 GP partners left their roles in the last year to June 2021 – a drop of 3.1%. At the same time there has been a shift in locum GPs moving to salaried roles as the pandemic has changed working structures.

Partners now count as a minority in headcount terms in a quarter of CCG areas, according to figures released by NHS Digital.

There were 17,035 full time equivalent GP partners in England in June 2021, down from 17,578 a year earlier and a massive drop of almost 12% since June 2018 when the FTE numbered 19,343.

GP partners still make up 61% of the fully-qualified FTE GP workforce. But in headcount terms just 53% of fully-qualified GPs were in partnership roles in June 2021, down from more than 58% just two years earlier.

GPs in salaried roles, meanwhile, are rising rapidly with 800 more GPs working as salaried GPs following uncertainty during the pandemic.

At the same time, appointments were up 31% compared with June 2019 once appointments for covid vaccinations were factored in.

Speaking to GPOnline Dr Fieldhouse, the chair of the National Association of Sessional GPs and the clinical director of a locum chambers organisation – said newly-qualified GPs in particular had decided to make the switch to salaried roles as they look to keep on top of student debt.

13-hour days

In comments collected by the BMA, a GP in the south of England said: ‘I’m a partner and in the past year I have lost a partner to early retirement and two partners to periods of sick leave due to the stress of the job.

‘You cannot talk about workforce in general practice without also talking about workload. We simply do not have enough GPs to cope with ever-expanding patient demand. Our funding assumes three patient contacts per annum for every patient on our list. We are currently running around seven per annum.”

Another GP in south-west England said: “I have just got home from another 13-hour day… Every time a GP reduces their hours or quits, or a post is unfilled, the strain on the remaining GPs increases.”

Locum work

During the pandemic, with the shift to alternative ways of working including total triage and carrying out more consultations by phone and video meant there were fewer locums needed. At the same time permanent members of staff were cancelling annual leave.

But with holidays back on the cards and many staff needing a break from what has been an incredibly difficult time for everyone in healthcare, bookings for locum staff have started to pick up.

Dr Fieldhouse suggested that about 1000 locums – or about 6% –  have switched to salaried roles. Estimates put the number of locums still working in that capacity as around 17,000.

Salaried GP roles are now the preferred career option, with a shift away from locum work over the last 12 months.

Earlier this month NHS England set an email to local commissioners to work with primary care networks to ‘help address the major underlying workforce and workload challenges facing general practice’. As part of this they urged commissioning groups to ‘create highly flexible GP salaried roles for those who previously thought that only a career as a locum could offer them the flexibility they need’.

Realigning supply and demand

“The number of locum GPs moving to permanent roles means there is a mismatch between supply and demand,” says Chief Commercial Officer at Medloop, Tom Thornton.  “There will always be a need for additional pairs of hands to come in and help meet patient demand and improvements in technology allows an evolution in how we manage these peaks and troughs in demand for clinical resources. 

“We’ve been working with PCNs around the country to help them meet the challenges of the patient backlog and ever increasing workload by working smarter and digitising many of the legacy processes which have not been updated for decades. 

“It’s exciting to see ideas moving from flow diagrams to becoming operational and seeing the ways we can help clinicians and patients together.”

Chief Medical Officer Dr Jay Verma believes that digital methods are being more widely accepted by patients now which can be used to both the patient and clinician’s advantage.

“The pandemic has changed the way of working and patients are used to making contact by text message and having virtual consultations – but they want to make sure it’s the right way of being seen.”

“We have a duty to keep primary care working for patients and for practitioners  – burnout is real and we can’t keep going at this pace – we need to make changes. 

“Those changes can be in both planned and unplanned care. By having resources dedicated to efficient treatment of chronic conditions you can free up resources for planned care.”

In the aftermath of the biggest peacetime crisis in health since the Spanish ‘flu we have to open the doors to primary care even wider than the front doors of GP practices – and that’s where Medloop comes in.

To find out more about Medloop’s planned and unplanned care pathways in primary care including how we can help you align these projects to central funding pots, contact us on contact@medloop.co