Almost 19 000 GPs will leave in next five years without urgent action, RCGP warns

General practice will lose around 18 950 GPs and trainees over the next five years unless steps are taken to tackle intense workload and workforce pressures, the Royal College of General Practitioners (RCGP) has warned.

The “mass exodus” is predicted by a recent RCGP survey of GPs’ career intentions, and is occurring against a backdrop of an overstretched and severely under-resourced service which is at breaking point and risks compromising safe patient care.

In response to the findings, the college has set out the actions that it believes are needed from the government to tackle the workforce and workload crisis in general practice and support practices to meet current healthcare challenges.1

Of the 1262 GP and trainee respondents to the survey, 42% said they are likely to quit the profession in the next five years—with 10% doing so in the next year and 19% in the next two years. With a current workforce of more than 45 000 GPs and trainees, this could mean that patients are set to lose almost 19 000 GPs and trainees—equivalent to more than 15 000 full time equivalent GPs.

Stress, working hours, and lack of job satisfaction were the reasons cited for quitting by 60% of those planning to leave for reasons other than retirement.

Overall, 68% of respondents said they did not have enough time to assess their patients properly, with 65% saying patient safety is being compromised because appointments are too short.

Martin Marshall, chair of the RCGP, said the findings were “alarming.”

“The intensity and complexity of our workload is escalating while numbers of fully qualified, full time GPs are falling. The college has been sounding alarm bells about the intense pressures GPs and our teams are working under, and the urgent need for support, since well before the pandemic, but covid has only exacerbated the situation. This is taking its toll on the health and wellbeing of GPs and other members of their teams—pushing many to consider leaving the profession earlier than planned,” he said.

There are currently more GPs in training than ever before, with an intake of 4000 in 2021. But even this, if sustained over the next five years and with all trainees entering the profession, would not be enough to counter the numbers planning to leave and sufficiently increase GP numbers, the RCGP warned.

The college is calling for a new recruitment and retention strategy to go beyond the current target of 6000 more GPs,2 and for an NHS-wide campaign to cut unnecessary workload and bureaucracy to free up GPs to spend more time with patients. It is also urging the government to invest in a new suite of IT products and support for practices to make it easier for patients to choose to see the same GP or the next available member of the team, and to returning funding for general practice to 11% of total health spend, including £1bn additional investment in GP premises.

Kieran Sharrock, deputy chair of the BMA’s England GP committee, said, “This stark warning from the college is one that the government can ill afford to ignore.”

Many areas highlighted as needing urgent attention—including premises, IT, bureaucracy, and resourcing—were ones the BMA “has raised continuously” with the government, he said. “The government must also tackle punitive pension rules that are forcing doctors to retire or reduce their hours when the health service and patients need them most.”

Wes Streeting, Labour’s shadow health and social care secretary, said that the Conservatives were “breaking” their 2019 manifesto commitment to deliver 6000 extra GPs by 2024-5, and that 300 GP practices had closed since the pledge was made.

The Labour Party said that analysis of NHS data show there were 32 200 GPs in 2013, compared with 27 700 today—a reduction of 4459.

The Department of Health and Social Care was approached for comment but had not responded by the time of publication.