How can we halt the decline in GP numbers?
Panorama highlighted an analysis by the Nuffield Trust think tank for the BBC last night, which showed the number of GPs per 100 000 people has fallen from nearly 65 in 2014 to 60 last year.
The last time numbers fell like this was in the late 1960s, and it comes at a time when the population is ageing and demands on GPs are rising. Patient groups said the fall in GP numbers was causing real difficulties in making appointments.There have been reports of waits of up to seven weeks for a routine appointment, while those needing urgent appointments have been forced to queue outside practices in the early morning to guarantee to be seen.
The Nuffield Trust analysis looked at the number of GPs working in the NHS – both full and part-time – per 100 000 people across the UK. It shows that during the late 1960s the numbers were falling, before four decades of almost continuous growth. A peak of 66.5 was reached in 2009, before the increases tailed off, and there have now been four consecutive years of falls, with the biggest drops being seen in England.
The NHS has been struggling to attract junior doctors to become GPs for a number of years. At one point, as many as one in 10 training places were going unfilled. This has now been rectified – and the number of training places has increased. Last year, nearly 3500 GP trainee posts were taken up in England, up by 800 since 2014. This boost in numbers has yet to be fully felt as it takes at least three years to train a junior doctor to become a GP. What is more, one in three junior doctors who accept places on GP training courses drop out of the system, according to the Nuffield Trust.
Meanwhile, the numbers retiring early have been increasing (two-thirds of retirements by GPs come early – double the rate seen just five years ago) and this is partly due to burn-out, but also the pension issue. Dr Richard Vautrey, of the BMA, said workloads were now ‘unmanageable’ for many, with doctors being asked to work longer and harder, without recognition or an increase in pay.
With hospitals referring more patients back to primary care, the system is under now extreme strain. Of course, more support staff would help, but at the end of the day the patients like to see their own GP. However, it feels as though too little is being done too late. Do you agree? What are you thoughts on the fall in GP numbers?