One in four GP surgeries faces staffing crisis

Research shows that a quarter of practices lose between 10 and 40 per cent of their staff each year

A QUARTER of GP surgeries are losing up to 40 per cent of their staff every year, researchers have warned, amid fears that the pandemic will exacerbate the “major crisis”.

In most NHS regions, GP staff resignations increased steadily between 2007 and 2019, according to a study by University of Manchester academics.

If a GP practice loses 10 to 40 per cent of workers within a year, it is deemed as having “high turnover”. If it loses more than 40 per cent of staff, it has “very high turnover”. The proportion of GP practices with high turnover almost doubled from 14 per cent in 2009 to 27 per cent in 2019. However, the proportion of practices with very high turnover remained stable, at 8 per cent.

Prof Evan Kontopantelis, co-author of the peer-reviewed study, published in the BMJ Open journal, said: “We already know the GP workforce in England is going through a major crisis.

“Rates of early retirement are increasing, as are intentions to reduce hours of working or leave their practice in the near future.

“Though in 2015 the Government promised 5,000 more doctors in primary care by 2020, the number of fulltime equivalent GPS per 1,000 patients continues to decline.”

Prof Kontopantelis added: “Quantifying GP turnover and understanding how it is distributed is fundamental to addressing challenges for the National Health Service, and for ensuring that quality and continuity of care are available to patients. We reveal worrying trends in GP turnover. High levels may affect the ability to deliver primary care services, and undermine continuity of care which in turn may affect the quality of patient care.

“And healthcare received from multiple GPS can lead to conflicting therapeutic treatments and fragmented care.

“Differential turnover across practices and regions could also lead to a maldistribution of GPS, exacerbating retention problems and health inequalities.”

The research comes after the British Medical Association published a survey in June that showed that more than a third of GPS – and nearly two thirds of those aged over 50 – planned to quit within five years, even before the damaging impact of the pandemic. Dr Samira Anane, BMA GP committee workforce policy lead, said at the time that despite the figures being “alarming”, they “will certainly not come as a surprise to many GPS as this has been a long-standing concern”.

“This research was carried out before the pandemic, and it is likely that the experiences that GPS have gone through over the last year has changed their outlook further…

“This desire is largely driven by unsustainable workload and the impact this has on doctors’ own well-being. GPS desperately need support from Government and policymakers as they face the most challenging time of their careers.”

She added that without intervention more doctors would be “forced to leave the profession, creating a vicious cycle where capacity is continuously outstripped by demand, threatening the level of care practices are able to offer”.

Earlier this summer, the BMA, the main doctors’ trade union, said many doctors were retiring early in order to avoid being hit with hefty pension tax bills. While 401 GPS and hospital doctors in England and Wales took early retirement in 2007-08, that number rose to 1,358 in 2020-21 – an increase of 239 per cent in 13 years.

The Government rejected calls to reform GP pensions taxation, arguing that the problem had already been addressed. In March, the Government raised the threshold income at which doctors see their tax-free pension allowance tapered, from £110,000 to £200,000, and announced the minimum level for reduction of the tapered allowance would be £4,000. However, the BMA and pensions experts warned the measures “do not go far enough”.

‘Rates of early retirement are increasing, as are intentions to reduce hours of working or leave their practice in the near future’

‘High levels of GP turnover may affect the ability to deliver primary care services, and undermine continuity and quality of patient care’