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GP workforce pressures put care of nearly a million Londoners in jeopardy survey shows

Almost a million Londoners face losing their GP as the workforce crumbles in the face of staff shortages, warns Dr Michelle Drage, Chief Executive of Londonwide LMCs, following a survey of over 1300 GP practices.

“Half our practices are short of a member of staff, a third are missing at least one GP and 128 practices, covering over 900,000 patients can’t rule out handing back the keys within three years. Hero GPs are working flat out to cover the gaps, but they’re at breaking point and need real support to keep caring for our growing city, and the growing complexity of its health needs” says Dr Drage.

“With junior doctors increasingly reluctant to take on the challenges of general practice, and many leaving the country in the face of the new contracting debacle, London's general practice future looks decidedly gloomy, delivering current service with fewer staff is unsustainable and unsafe in the long term. Let alone for extended seven day services.

"Until financial stability is secured and the low morale of existing staff is improved there is little prospect of the junior doctors currently coming through the ranks being the saviours. The oft-quoted influx of 5000 new GPs seem less and less likely with every day that passes.

"Our general practices are the hub of the NHS - providing for 90% of patients' needs on a paltry eight percent of its budget - and falling. To secure the future of general practice for the citizens of London we need more resource and more support. And we need it now, before it is too late" adds Dr Drage.

Survey findings

Vacancy numbers

The Londownide LMCs / ComRes survey of London GP practices had responses from 644 of the 1330 unique practices in the capital represented by Londonwide LMCs, of which 49% say they currently have a staff vacancy and 31% say they have at least one GP vacancy. Of the 199 practices with GP vacancies, 158 practices say they have at least one unfilled employed GP position.  50 practices say they have at least one unfilled GP partner position.

Vacancy lengths

On average employed and partner GP posts are said to have been vacant for over eight months after a doctor leaves. The workforce problems are exacerbated by high numbers of impending retirements, with 44% of GP practices (284) saying their practice currently has GPs planning on retiring in the next three years.

Half of practices say financial uncertainty about the future of the general practice model is preventing staff recruitment. Other factors cited include, low morale within the GP profession (45%), pay (43%) and lack of suitable GPs interested in the position (41%).

Closure

The 19 practices which say they are planning to terminate their contract to provide GP services in the next three years represent 116,491 patients.* 62% of practices that say they are planning to terminate their GP contract in the next three years say they currently have a vacancy of some sort, compared to 46% of those that are not planning to terminate their GP contract in the next three years.
And a large proportion of practices do not rule out termination as an option – 109 practices, representing 802,383 patients, say they do not know if their practice has plans to terminate its GP contract in the next three years.*

37% of London practices say they are considering employing additional locum staff to help manage current and future vacancies, while 13% are considering reducing services and 4% are considering closure. The survey reveals that 197,883 patients would have to find a new GP if those 4% of practices considering closure go ahead.*

Combined, 39 practices are either planning to terminate their contract in the next three years or are considering closure to manage current or future vacancies. Kensington and Chelsea and Barnet are the worst affected boroughs, and could stand to lose five and four practices respectively.

*Numbers of patients affected by possible closures or contract terminations are estimated based on the median number from the patient list size range indicated by each practice responding.

Key stats

• Only 39% of GP practices surveyed say they do not currently have any GPs planning on retiring in the next three years.
• Of the 313 practices with a vacancy 199 had at least one employed GP, partner GP or freelance locum GP vacancy.
• GP partners are business owners who carry much of the load for running practices and keeping them in line with complex regulatory and contractual requirements.
• The mean length of GP vacancies has been calculated from the stated length of current vacancies for employed GP and partner GP posts, as provided by respondents.

Last updated : 15 Feb 2016

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