Patient safety threatened by mass exodus of GPs

Publication date: 04 July 2014

Almost eight per cent of the entire GP workforce left frontline patient care in the latest year for which figures are available

Record numbers of family doctors in England are leaving general practice due to ballooning workloads in a ‘mass exodus’ that could spell disaster for the future of patient safety, the Royal College of General Practitioners has warned today.

In the biggest exodus on record, almost eight per cent of the entire GP workforce left frontline patient care in the latest year for which figures are available.

By the end of 2013, there were 35,561 GPs in England. This was down on the number in post in 2009, when there were 35,917.

The College says that a toxic mix of increased demand – caused by a growing and ageing population – and plummeting levels of resource has led to thousands of GPs having to work at unsustainable levels to try to meet patient demand.

According to polling, conducted on behalf of the College, 96% of family doctors believe that working in general practice is more stressful now than it was five years ago and 22% have had to seek support, guidance or advice for work-related stress.

Losing almost eight per cent of GPs is not only a threat to patient safety – but is also a waste of public money as it costs £247,000 to train medical postgraduates to become family doctors.

With the majority of GPs now conducting between 40 and 60 patient consultations a day, and half of all family doctors working at least 11 hours each day, growing numbers are retiring early or migrating to other countries. The College says the ‘mass exodus’ poses a grave threat to the future of patient care.

Six years ago just 4.7% GPs (or 1,583 individuals doctors) left the profession. However, by 2012/13 the proportion of GPs turning their back on the profession had leapt to 7.7% (or 2,726 individual doctors).

During the last six years for which records are available thousands of GPs have left the profession:

  • In 2008/09, 4.7% (1,583) of GPs left the profession
  • In 2009/10, 7.1% (2,477) of GPs left the profession
  • In 2010/11, 6.4% (2,249) of GPs left the profession
  • In 2011/12, 6.9% (2,451) of GPs left the profession
  • In 2012/13, 7.7% (2,726) of GPs left the profession

The number of family doctors leaving general practice has increased across all age ranges, particularly those in their thirties and forties, who still should have many years left to work in English general practice.
 
In 2008/09, 170 GPs aged between 30-34 left the profession. By 2012/13, this number had increased to 313

  • In 2008/09, 196 GPs aged between 35-39 left the profession. By 2012/13, this had increased to 389
  • In 2008/09, 161 GPs aged between 40-44 left the profession. By 2012/13, this had increased to 255
  • In 2008/09, 127 GPs aged between 45-49 left the profession. By 2012/13, this had increased to 200
  • In 2008/09, 130 GPs aged between 50-54 left the profession. By 2012/13, this had increased to 275

While the number of patients seen by family doctors and practice nurses has increased from 304m in 2008/09 to 360m in 2013/14, funding for general practice has been falling continuously for the last decade – with general practice now doing 90% of the NHS patient contacts for just 8.39% of the NHS budget.

As growing numbers of GPs leave the profession, particularly those who are early-to-mid career, GP surgeries will find it increasingly difficult to deliver decent patient care – with an increasing number of practices at risk of closure due to a lack of GPs.

The College says the only way to stem the growing problem is for the Government to increase funding for general practice to 11% of the NHS budget by 2017, and to ensure that 8,000 additional GPs are recruited in England.

Dr Maureen Baker said: “The mass exodus of GPs – driven by soaring demand and plummeting resources – is a clear and present danger to patient safety.

“GPs across the country are wilting under the weight of ballooning workloads, with thousands of being driven to retire early or emigrate to practice in less stressful settings. 

“Not only is this a tragedy for patients, but it is also a waste of public money – as it costs £247,000 to put a family doctor through post-graduate training.

“Unless we can stop GPs leaving the profession we simply will not be able to cope with the continuing explosion in demand – which it is estimated will generate an additional 37m requests for consultations from patients in England over the next three years.

“Ultimately, if general practice tips over the edge further pressure will inevitably be heaped onto our hospitals.

“The only way to stem this emerging crisis is for the Government to increase investment in general practice to 11% of the NHS budget by 2017 and to recruit an additional 8,000 GPs in England to meet soaring patient demand.”

Dr Patricia Wilkie, President and Chair of the National Association for Patient Participation (N.A.P.P) said:

“N.A.P.P is increasingly concerned that record numbers of GPs in England are leaving general practice.

“More people are living longer and many of these people have several long term conditions requiring the time and skill of their general practitioner. But we know from our members that patients are experiencing very considerable difficulties in obtaining appointments, either in an emergency or with a doctor of their choice.

“While the number of patients seen by family doctors and practice nurses has increased, funding has dropped over the last decade.

“N.A.P.P supports the college in recommending the need to increase funding for general practice to 11% of the NHS budget by 2017.

“It is essential that 8,000 additional GPs are recruited in England to ensure that GPs can deliver the high standard of medical care that they wish to give and that patients deserve.”

Further Information

RCGP Press office - 020 3188 7574/7575/7576
Out of hours: 0203 188 7659
press@rcgp.org.uk

Notes to editor

The Royal College of General Practitioners is a network of more than 44,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.

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