GP workforce crisis is predicted as earnings fall for seventh year in a row

BMJ 2014; 349 doi: (Published 22 September 2014) Cite this as: BMJ 2014;349:g5781
  1. Gareth Iacobucci
  1. 1The BMJ

GPs in the United Kingdom have seen their income fall for the seventh successive year in real terms, as rises in practice expenses continue to outstrip increases in earnings.

New figures published by the Health and Social Care Information Centre show that the average income in real terms of contractor GPs (those working under national General Medical Services (GMS) and local Personal Medical Services (PMS) contracts) was £102 000 (€130 000; $170 000) before tax in 2012-13, down from £104 100 in 2011-12 (figure).1 The figures mean that the annual income of contractor GPs has fallen by 22% in real terms since 2005-06, when it stood at £129 994.

The report showed that the ratio of expenses to earnings for contractors, which is calculated by comparing gross earnings with practice expenses, has risen from 55.1% in 2005-06 to 62.5% in 2012-13.

The BMA’s General Practitioners Committee said that the fall in income had coincided with a rising workload in primary care, and it warned of a looming workforce crisis as a growing number of doctors opted to leave general practice. The report found that the income of salaried GPs (those employed permanently by practices but who are not partners) also fell slightly, from £56 800 in 2011-12 to £56 400 in 2012-13 (a drop of 0.6%).

In cash terms, the annual decrease in average earnings for contractor and salaried GPs combined between 2011-12 in 2012-13 was 1.4% (from £94 200 to £92 900). Wales had the sharpest decrease, of 2.2% (from £88 800 to £86 900), England’s fell by 1.6% (£95 700 to £94 200), Northern Ireland by 0.6% (£92 800 to £92 200), and Scotland by 0.1% (from £85 100 to £85 200).

The report used data from HM Revenue and Customs’ self assessment tax records to calculate the figures.

Chaand Nagpaul, chairman of the General Practitioners Committee, said, “This [report] highlights the government’s continued inadequate investment in general practice, which is not keeping up with the rising expenses of running a GP practice to meet the increasing volumes of care GPs provide.

“GPs are also working in an increasingly pressurised working environment of rising patient demand and falling resources that is being exacerbated by the government’s desire to move unfunded work from hospitals and into the community. Many GP premises are too cramped to provide adequate care, with a recent BMA survey showing that four out of 10 GPs said that their practice was struggling to provide basic GP services.

“These problems combined are increasingly affecting the GP workforce, with seven out of 10 current GPs now saying they are considering early retirement, and hundreds of vacancies being recorded for GP trainee posts this year.” Nagpaul added, “Despite this environment, GPs are working harder than ever before for their patients, getting through 340 million consultations each year, up 40 million since 2008. But we need to start supporting GPs appropriately so that general practice and its workforce are properly valued and enabled to meet the growing needs of the population they serve.”

Commenting on the findings, Kingsley Manning, chairman of the Health and Social Care Information Centre, said, “Contractor GPs have seen an increase in their expenses, higher than the increase in their gross earnings, which has meant that their taxable income is less than last year.”


Cite this as: BMJ 2014;349:g5781


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