Trends in the shortfall of English NHS general practice doctors: repeat cross sectional study

Abstract Objectives To compare the numbers and characteristics of English general practitioner doctors (GPs) across publicly available data sources, and to examine trends in GP numbers relative to population growth and the specialist medical workforce in England. Design Repeat cross sectional study. Setting Three national data sources, England, 2012-24: General Medical Council (GMC) GP and specialist registers; NHS England GP Performers List; and NHS England’s General Practice Workforce and NHS Workforce Statistics datasets. Participants All GMC licensed, fully qualified GPs in England. Main outcome measures Differences over time in total numbers and GP characteristics. Changes in the difference between GMC and NHS general practice GP numbers and characteristics, and analysis of trends relative to population size and equivalent data on specialist doctors. Results As of 31 December 2024, 58 548 GPs were listed on the GMC GP register, 55 958 on the Performers List, but only 38 626 by headcount and 28 197 by full time equivalent GPs in NHS general practice. Between 2015 and 2024, on average, for every five additional GPs licensed by the GMC, NHS general practice lost one full time equivalent GP each year. As a result, the proportion of GMC licensed GPs not working in NHS general practice increased from 27% (13 492) in 2015 to 34% (19 922) in 2024 by headcount and from 41% (20 210) to 52% (30 351) by full time equivalent GPs. Differences were greatest among female GPs, younger GPs, UK qualified GPs, and GPs in London and the South East of England. In contrast, between 2015 and 2024, for every five additional GMC licensed specialist doctors, the NHS gained 4.3 full time equivalent consultants. Taking population growth into account, the number of NHS patients for each full time equivalent GP in NHS general practice increased by15%, whereas the number of patients for each full time equivalent NHS consultant fell by 18%. By the end of 2024, there were twice as many NHS patients for each full time equivalent NHS general practice GP (2260) than for each full time equivalent NHS consultant (1092). Conclusion The growing difference between GMC licensed GPs and those working in NHS general practice is in contrast with trends among specialists. This shift is occurring despite rising patient demand and policy commitments to strengthen primary care. Addressing the underlying reasons for workforce attrition in NHS general practice is critical to achieving the government’s stated goals of strengthening community based care and shifting the focus of care from treatment to prevention.