GPs in deprived areas earn £5,500 less a year on average

GPs in England’s most deprived areas earn £5,525 less per year on average than those in wealthier areas, a new study has found.

Practices in areas of socioeconomic deprivation endure ‘increased job pressures’ related to managing complex patients, insufficient resources and difficulty in finding locum cover, the analysis by University of Manchester also showed.

The researchers looked at data from over 8,500 GPs between 2015 and 2021 included in the GP Worklife Survey, a national survey conducted every two to three years in England and commissioned by the Department of Health and Social Care.

The study, published in the Journal of the Royal Society of Medicine, found that deprivation ranking was associated with ‘significantly lower reported annual income’ and with higher pressures related to ‘perceived problem patients’.

However, despite higher job pressures, there were no differences in overall job satisfaction, hours worked per week or intentions to leave patient care between GPs working in more deprived and less deprived areas.

The study said: ‘When pooling all survey data together, there were no statistically significant associations between deprivation ranking and composite scores for job pressures (0.051, 95% CI: −0.020, 0.122), job satisfaction (−0.008, 95% CI: −0.111, 0.094), and intentions to quit (0.017, 95% CI: −0.024, 0.059).

‘There was also no statistically significant association between deprivation ranking and hours worked (−0.558, 95% CI: −1.887, 0.772), but there was a statistically significant negative association with reported GP income (−£5,525, 95% CI: −£8,773, −£2,276).’

It suggested that policymakers should increase funding so that deprivation is ‘taken into account’ as a factor in general practice funding to address income disparities and improve retention.

The researchers concluded: ‘Perceived problem patients, insufficient resources and finding temporary cover are key drivers of GP job pressures in practices serving more deprived populations.

‘GPs in more deprived areas also report lower incomes. These factors should be the target of increased investment and policy interventions to improve recruitment and retention of GPs in these areas.’

Lead researcher Dr Michael Anderson, a GP and NIHR clinical lecturer at the University of Manchester, said that the study showed how the socioeconomic deprivation of practice populations in England is ‘adversely linked’ to the working conditions of the GPs that work there.

He said: ‘We highlight a clear and persistent challenge in ensuring equitable healthcare provision.

‘Without targeted investment and policy interventions, the difficulties faced by GPs in deprived areas will only continue to worsen, exacerbating health inequalities.’

When analysing the specific sources of job pressure, the researchers found that deprivation ranking was associated with ‘significantly higher pressures’ related to ‘perceived problem patients, insufficient resources within the practice and finding a locum’.

According to the researchers, the findings explain why working in areas of greater deprivation is ‘less attractive’ to GPs, exacerbating workforce recruitment and retention issues.

Dr Anderson added: ‘Alongside financial incentives, non-financial incentives such as enhanced career development opportunities including fellowships that incorporate time for additional training, research, and leadership responsibilities could be a useful lever to promote GP recruitment and retention in areas of greater deprivation.

‘We also think it’s important to acknowledge we find no differences in hours worked per week, job satisfaction, and intention to quit direct patient care in more deprived and less deprived areas.

‘Despite the challenges experienced by GPs working in areas of greater deprivation, this suggests that there are many rewarding aspects of working in areas of greater deprivation. 

‘A broader recognition by the GP community of the potential advantages of working in areas of greater deprivation would therefore be helpful to promote recruitment and retention.’

Senior study author Professor Matt Sutton said: ‘Though deprived populations have higher needs for GP services, we know these areas have the most difficulty recruiting and retaining GPs.

‘Our study is the first to examine how working in deprived areas affects the working lives of GPs. Addressing their concerns about increased job pressure and decreased resources would help reduce health inequalities.’

Last year, RCGP research found that GPs in deprived areas care for almost 2,500 patients per head, which is over 300 more than those in more affluent areas.

Pulse’s recent major investigation found clear evidence that deprivation and funding are contributing to the current recruitment and unemployment crisis that GP practices are facing.