Just over 40% of GP registrars who qualified in 2022 and 2023 have not yet taken up substantive roles in UK general practice, NHS data analysis has suggested.
NHS Digital recently published a new analysis of the number of GPs in training who transition into the fully-qualified workforce, and how long it takes them to do so, using official GP training and general practice workforce data.
The analysis therefore indicated the number of GPs who seem to disappear between ST3 and substantive posts at ‘traditional high street practices’.
However, there are a number of caveats, including the fact that the data does not capture GPs who work as ad-hoc locums in NHS general practice or those employed by PCNs (see box).
This means that for more recent GP qualifiers, the data does not capture those who may have been hired by the ARRS since the health secretary expanded the scheme to include doctors.
For GP ST3s last seen in the training data in 2022 and 2023, 40.3% of them had not, by December 2024, turned up in a substantive post in UK general practice.
The data suggested that this rate of GPs ‘disappearing’ has increased in more recent years, as for ST3s who qualified in 2020 and 2021, only 28% of them have not been recorded in a substantive post (see table).
However, NHS Digital highlighted: ‘It is important to be aware that from the results, it can be seen that GPs are still transitioning into the workforce after several years and so transition rates are likely to increase in future quarters, particularly for the more recent periods.’
Total Number seen in a substantive role by Dec 2024 Number not seen in substantive role by December 2024 % not yet seen in substantive role ST3s last seen in 2020 and 2021 5336 3843 1493 28% ST3s last seen in 2022 and 2023 6129 3657 2472 40.3%
The BMA’s GP registrars committee claimed that this same dataset shows that 25% of GPs did not take on a substantive role within five years of qualifying.
This was calculated by looking at the average proportion of GPs who obtained their CCT over five years ago and who had not shown up in the general practice workforce within those five years.
Responding to the data, GP registrars committee co-chairs Dr Cheska Ball and Dr Vicki McKay pointed to the GP unemployment crisis, saying it is ‘absurd’ that doctors are willing to work but ‘practices are unable to employ them’.
They continued: ‘To have a quarter of GPs not working in substantive GP roles five years after qualifying represents a monumental waste of skills and money.
‘It sends completely the wrong message to resident doctors deciding where to specialise, and does nothing to solve the recruitment and retention crisis in general practice.’
Doctors’ Association UK GP spokesperson Dr Steve Taylor told Pulse that the large proportion of IMG GP registrars may be fuelling this issue.
He said: ‘Given half of all trainees are IMGs, many of whom require visa extensions, I suspect some are taking roles outside of GP when no jobs become available, or leaving altogether.
‘There is clearly a problem for many GPs taking up roles. Worse even when they are seen in roles, a quarter of the younger GPs are leaving.
‘So there is a problem both with finding an initial job, but even when they do many are not staying.’
Dr Rachel Ward, representative of the Rebuild General Practice campaign, said the the decline in GP registrars taking up qualified positions ‘represents a costly brain drain for taxpayers’.
She continued: ‘We cannot expect future doctors to be inspired to enter general practice without assurance that they can help patients through both medical issues and life challenges.
‘Focusing on training and recruitment without retention won’t solve the crisis. Too many GPs are training in the UK and moving to work abroad over better pay, burnout, and unmanageable workloads.
‘Urgent investment in general practice is needed to retain practitioners and provide patients with lifelong continuity of care.’
Explanation of GP workforce data
- It provides a quarterly supply of information on the number of GPs in training who transition into the fully-qualified workforce, and how long it takes them to do so, by linking Training Information System (TIS) with National Workforce Reporting Service (NWRS) data.
- The TIS data has then been linked to each quarterly extract from NWRS using GPs’ GMC numbers to attempt to find the same GPs in fully-qualified roles.
- The fully-qualified GP roles included are GP Partner, Salaried GP, GP Retainer and Regular GP Locum (covering sickness, maternity/paternity, vacancies).
- A large proportion of the GPs counted as ‘not yet seen’ in the workforce may therefore be:
- Ad-hoc locums;
- Working but not recorded by their practice;
- Working in other settings – OOH, 111;
- Working privately;
- Working abroad.
- NHS Digital warns that the real transition rates of ST3s to GP workforce ‘are likely to be much higher’ given these caveats.
Source: NHS Digital
Pulse’s major series on the GP unemployment/recruitment crisis examined more recent trends, revealing that around a quarter of salaried GPs and locums are looking for a permanent role at the same time as practices are facing a shortfall in GP numbers.
The report also found that around a quarter of practices have had to shrink their team size due to financial pressures, while four in 10 GPs see themselves leaving UK general practice in the next five years.
We need to know how long they ‘disappear’ for, and if the proportion reduces over time.
We had trainees on our VTS in 1990s from overseas who fully intended to return to their country of origin after finishing VTS – one of the allowances we need to consider for a world-leading GP-training service!
And, 3 years after finishing my VTS course in UK, I was not working in the UK at all, but by 4 years after, I was in a substantive GP Practice position, after a short period of locum work on return to the UK.
These numbers shouldn’t come as a shock. Being a GMC registered doctor , with all the liability for problems patients face with none of the resources , is criminial . most doctors who train in our surgery are already looking at australia, new zealand and Canada as they know they can’t locum in the up (no work) and do not want to take on the stress and risk of partnership/salaried or ooh work which is often toxic and a detriment to their own mental health. Fix general practice and give doctors some basic human rights. Things might change. until then, it is a problem created by the NHS. If you don’t look after doctors, how can you expect them to look after the patients?
up=UK