In the last few weeks we’ve seen politicians from different parties make a number of apparently contradictory claims about GP numbers, all of which are missing at least some context.
On 1 March, the Prime Minister Rishi Sunak told the House of Commons that there were a “record number of GPs”.
Then on 7 March, the health secretary Steve Barclay told MPs that there were “2,200 more doctors in general practice than before the pandemic”.
More recently, the Liberal Democrats have made very different claims about GP numbers, with party leader Sir Ed Davey telling BBC Breakfast on 29 March that “actually the number of GPs has gone down” since the last election in 2019, and MP Sarah Olney claiming at Prime Minister’s Questions on the same day that “there are 850 fewer GPs in the country than there were in 2019”.
These claims are at odds because they are based on different statistics measuring the number of GPs, and none of them tell the full story about recent changes in the GP workforce in England. (All the figures in this fact check relate to GP numbers in England—health spending is devolved so the UK government is only responsible for health spending in England.)
It is important that politicians use data accurately and transparently, and explain any necessary context when making claims. Statistics on their own have limitations. The way they are presented is a crucial part of how they are interpreted and understood by the public. If data is presented without context or caveats, it can give an incomplete or misleading picture.
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What numbers were the politicians using?
Mr Barclay’s claim about the rise since before the pandemic is correct when looking at the headcount number of GPs, though the increase is slightly lower when you look at the full-time equivalent (FTE) figure, which gives a better idea of staffing levels.
The 2,200 increase he referred to also includes trainees, who some argue should not be counted in the same way as fully qualified GPs. By holding longer consultations and having allotted time for their education, trainee GPs may see fewer patients than a qualified GP, while some trainees will not go on to become full-time qualified NHS GPs when they complete their training.
If you discount trainees and look at FTE figures, the number of fully qualified GPs has actually fallen since December 2019.
Mr Sunak’s claim about there being a record number of GPs appears to be based on the fact that in August 2022 the total GP headcount and FTE numbers hit a record high. Since then the numbers have fallen slightly, though this may reflect seasonal factors as GP numbers tend to peak at the end of summer, then fluctuate slightly across the year. Again, Mr Sunak’s figures also include trainees.
Meanwhile Liberal Democrat claims that GP numbers have actually fallen relate to the number of FTE fully qualified GPs, so don’t count trainees. The party put out an embargoed press release on 28 March (not yet published online) which used NHS Digital’s data to calculate that FTE fully qualified GP numbers fell by 852 between December 2019 and February 2023—as highlighted by Mr Davey and Ms Olney.
Neither Mr Davey nor Ms Olney specified that they were talking only about this measure rather than the total headcount of GPs, which could be misleading—though some health experts say the metric they used is actually a more reliable way of comparing GP numbers.
What does the data show?
NHS Digital data published in February (the most recent available when Mr Barclay and Mr Sunak made their claims) shows that there were around 45,600 GPs working in the NHS in England at the end of January 2023. That’s about 2,230 more than the roughly 43,370 in December 2019. (New data published since shows that at the end of February 2023 there were 45,760 GPs.)
These figures measure ‘headcount’—in other words, the number of individual GPs employed, without taking account of the hours they work.
But looking just at the headcount figure doesn’t tell us much about the working capacity those people have—some may work part-time, for instance. So to get a better idea of staffing levels, we can look at the number of hours these GPs all work and add these together to work out how many full-time roles they make up. The jargon for this in the workforce data is ‘full-time equivalent’, or FTE.
When looking at the total number of FTE GPs, the NHS Digital data shows the increase since before the pandemic is slightly less than Mr Barclay said. There were around 1,900 more FTE GPs in January this year than in December 2019.
The total number of GPs peaked—and in fact, hit all-time record levels—in August 2022, when by headcount it was about 46,310 and by FTE 37,090.
However the rising total number of FTE GPs includes about 9,220 in training grade, according to the most recent figures up to the end of February published in March, which represents a roughly 2,830 rise from the 6,390 trainees recorded in December 2019.
This suggests that year-on-year increases in the total number of GPs may be fuelled by a sharp rise in the number of trainees.
Trainees do not generally hold as many consultations with patients as fully qualified GPs. They are expected to have dedicated education time and may carry out fewer and longer appointments than a qualified colleague. These appointments may also be supervised by fully qualified GPs, who will then not be able to see as many patients themselves.
The Royal College of GPs’ (RCGP) chair Professor Kamila Hawthorne told Full Fact: “We would advise against counting trainees, as whilst GP trainees do see patients, they are primarily in training to learn, and will be seeing patients under supervision.
“They may be working to a different schedule than qualified GPs—for example, they may have longer time with patients, and will also need appropriate time for reflection and other learning.”
The Department of Health and Social Care told Full Fact that trainee GPs were fully qualified doctors that deliver direct patient care whilst being supervised, help to ease workloads, and deliver more appointments.
Health Education England (HEE) says that new GP trainees now spend two years of their three-year training programme in general practice, after completing a year of hospital-based training rotations. This was increased from 18 months for all trainees joining the programme after August 2021.
It adds that during their final year of training, trainees will have a minimum of three sessions of education (each around four hours) each week and will be supported daily with debrief sessions after surgeries and home visits.
Beccy Baird, senior fellow at The King’s Fund, said: “Counting the number of GP trainees is useful for knowing how many GP trainees there are.
“It is much less useful when thinking about how many GPs are currently available to provide patient care.”
If you exclude trainees and instead look at fully qualified FTE GPs, as the Liberal Democrats did, the data shows that the number has fallen from roughly 28,130 in December 2019 to around 27,280 in February 2023.
The Health Foundation, which has published its own analysis of GP workforce data, argues that “the best measure of GP workforce capacity” is the number of FTE fully qualified permanent GPs—ie, discounting locums too. It argues this is because locums, while fully qualified, often cover for other GPs who are absent due to sickness or maternity leave.
If you look just at FTE fully qualified permanent GPs—ie, excluding trainees and locums—the data shows there were 26,630 in February 2023, down from the 27,120 reported in December 2019 and a peak of 28,680 in March 2016.
Where do GP trainees go on to work?
The NHS Digital data is a snapshot of the workforce in GP surgeries on a specified date, including trainees. However, crucially this means the data actually underestimates the total number of doctors in GP training in England at that time, as it does not include those working elsewhere—for example those on hospital rotations.
While the monthly data shows that there were around 9,220 GP trainees working as of the end of February, HEE told Full Fact that there are in fact 13,847 GP trainees by headcount currently on the programme.
On the other hand, not all the trainees will convert into an equivalent number of full-time fully qualified GPs.
Ms Baird told us: “Research from The King’s Fund shows that most intend to work five to six half-day clinical sessions a week in general practice.
“Given the workload complexity GPs now face, a half-day session, in reality, lasts much longer than four hours, and so six half-days a week can easily equal 37 hours or more.”
According to the NHS, a full-time GP would be expected to work eight sessions a week.
In addition, some GP trainees will not go on to work as NHS GPs in England, Ms Baird said: “About 40% of current GP trainees are international medical graduates, not all of whom will stay in England.”
The RCGP said a 2022 survey of its members found that 30% of international medical graduate GP trainees consider not working as an NHS GP because of difficulties with the visa process.
Full Fact has not been able to find official figures for how many GP trainees go on to work for the NHS, but we’ve approached the General Medical Council for more information.
We’ve also asked Downing Street for comment.
Full disclosure: The Health Foundation has funded Full Fact's health fact checking since November 2022. We disclose all funding we receive over £5,000 and you can see these figures here. (The page is updated annually.) Full Fact has full editorial independence in determining topics to review for fact checking and the conclusions of our analysis.
Image courtesy of Hush Naidoo Jade Photography.