An article published in the Daily Express on 21 September 2022, also published online, claims that “1 in 4 could be without a GP within ten years”.
That figure, which was widely reported elsewhere as well, comes from an open letter published by Doctors’ Association UK (DAUK) to health secretary Dr Thérèse Coffey, which calls for the government to take action to address issues within the primary care system.
The letter says: “The Health Foundation warns that unless something changes, the NHS will lose up to 8,800 full-time equivalent GPs by 2030. We estimate this could leave up to 16 million people without an NHS GP within the decade.”
However this does not accurately describe the Health Foundation’s estimate, which was actually for the projected shortfall in GPs needed to maintain pre-pandemic standards of care over the coming decade rather than the number leaving the NHS. And the Health Foundation has told Full Fact that the suggestion that 16 million people could be without a GP by 2030 “cannot be inferred by our workforce projection analysis”.
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What do the Health Foundation figures show?
The figures published by the Health Foundation in June 2022 projected that under current policy roughly 1 in 4 of the 37,800 full-time equivalent (FTE) GP posts needed to offer pre-pandemic standards of care by 2030/31 would be vacant. This is in relation to the situation in England only, as are the rest of the figures in this article.
As of August 2022 there are currently 26,822 FTE qualified permanent GPs in the NHS in England, with the Health Foundation projecting this figure will be around 29,000 in 2030. However the projections estimate that the demand for FTE GPs will also increase, from 31,300 in 2022 to 37,800 in 2030.
Therefore the Health Foundation did not say, as DAUK claimed in its letter, that the “NHS will lose up to 8,800 full-time equivalent GPs by 2030” but rather that the number of FTE GPs in 2030 is expected to be 8,800 short of the number required to meet “pre-pandemic appropriate standards of care”.
How was the 16 million figure calculated?
DAUK told us it multiplied the Health Foundation’s projected shortfall of roughly 8,000 by the current estimate of the number of patients per GP in the UK—around 2,000—to come up with its estimate that 16 million people might be left without a GP within a decade.
While there are many variables that could affect what actually happens in 2030, this calculation makes a number of assumptions, including that understaffed GP practices will close their lists rather than adjust the level of care they provide, and that every GP post which isn’t filled will result in patients being unable to register.
Elaine Kelly, Head of Economics Research at the Health Foundation, told Full Fact: ‘We projected how many GPs would be needed to deliver the same level of care as 2018/19 to a future population. Our projections show we will be around 23% below what is needed to deliver that level of care by 2030/31.
“However, that does not mean that millions will be without a GP. It is more likely that they will have GP but the level of care will not be the same as 2018/19 and they will have to wait longer. They may then choose to use other services.”
Full Fact contacted DAUK about its interpretation of the Health Foundation’s figures, and a spokesperson told us: “Without a shift in current policy, and if workforce numbers continue to decline, GPs will be left with the stark choice—provide ever-increasing levels of potentially unsafe care or close their lists as suggested by the BMA.
“Given our GMC licences, and therefore our livelihoods, depend on being able to deliver safe care, DAUK maintains there is a very real possibility that practices will close their lists, in order to provide safe care to their already registered patients. If this happens, in conjunction with the projected forecast of reducing GPs, then patients could be left without an NHS GP. We have seen this precedent already set in NHS dentistry, with lists closing and therefore some areas left without NHS provision.
“Indeed there are already examples this year of practices attempting to close their lists in England and Northern Ireland.
“These are of course projections, and no one can say for certain what is going to happen, but it is possible a large portion of the population could struggle to access a GP if we continue on the current trajectory. We implore the new Government to take these warnings seriously and urgently implement policy to ensure all patients retain good access to their GP.”
Image courtesy of Sasun Bughdaryan