In the autumn of 2023, Pulse started receiving reports of GPs being out of work in England. This was a shock; for the past decade the narrative had been entirely around the lack of GPs and practices being unable to recruit. Since autumn 2023, we have heard more and more stories of GPs being out of work. We have reported on locums having to travel from Cumbria to Cornwall to get work. We have heard dire warnings around newly-qualified GPs being left unemployed.
There has been acknowledgement from the Government around this situation. In one of his first acts as health secretary, Wes Streeting announced that newly-qualified GPs would be added to the additional roles reimbursement scheme to prevent a cohort of doctors starting their career unemployed.
But this situation of unemployed GP doesn’t seem to have permeated the public consciousness. The narrative continues to be centred around access issues and, with it, the belief that there is still a recruitment crisis.
This is not a misguided belief, however. Because practices are still short of GPs, and many are still struggling to attract them. So how did we end up with Schrodinger’s workforce crisis: GPs out of work and practices struggling to recruit GPs?
A new six-part series from Pulse seeks to address this question. Released over the next few weeks, we will look at the reasons some GPs are out of work at the same time practices need to recruit. We will examine the ICB areas where there are fewer GPs and what characteristics – such as funding, deprivation and patient demographics – determine whether a practice is relying on other healthcare staff. We will ask what effect the ARRS has had on the workforce, the training pipeline and what ICBs, PCNs and practices are doing to alleviate these problems.
This series is based on a major new white paper from the publishers of Pulse, Cogora, on the changing general practice workforce in England, in conjunction with the Rebuild General Practice campaign group. Alongside our sister titles – Pulse PCN, Healthcare Leader, Management in Practice, Nursing in Practice and The Pharmacist – we have surveyed around 2,500 general practice professionals, interviewed more than 100 frontline practitioners, analysed hundreds of data for every practice in England and brought together all the editorial expertise within our titles.
The white paper is being launched at a Parliamentary event tomorrow, which will be attended by MPs, GP, nursing, pharmacy and practice manager leaders, and numerous frontline GPs.
We are aiming for this report to influence GP contract negotiations, helping make the case for more funding and improved premises for general practice.
Keep an eye on our dedicated section over the next few weeks.
You can find all the data and the methodology in the full report. Click here to download the full report
Pulse October survey
Take our April 2025 survey to potentially win £200 worth of tokens
As a locum GP, patients say to me
You are the first GP i have seen in ages
Or
So GPs do exist in this practice.
Its the lack of funding that currently limits GP employment
Make being a GP partner an attractive properly funded career path again
I have been a GP for 37 years . 30 as a partner until we had to shut our practice . The last 9 years I have been a Locum and never been without work . That stopped last September and now there is no work . Nothing . It seems practices are taking on newly qualified GPs which is absolutely fair enough , but there is no need for locum it seems . My 41 years of medicine mean I have seen and dealt with most things . I have massive experience . I can see as many patients as you like in a day . However I am not needed . It’s funny as my friends tell me they cannot see a Doctor in their practice for up to 6 weeks . Is it all about money ? We older GP’s can offer a lot , we are still fit enough to do the job , we have wisdom and massive amounts of experience but it seems the NHS would perhaps rather we retire or bow out quietly . Oh well may just go off around the world on my motorbike
APMS practices ill thought out by irrational CCGs/ICBs along with NHSE were one of the pathways to decline followed in current times by PCNs. Some of course operate to a high standard but I am referring to a smaller select group. We presently have APMS practices run by GPs as additional practices, essentially in my opinion as ‘Cash Cows’ with these GPs already having their own separate practices as partners and running these secondary APMS practices simply for profit . They further manipulate and increase their financial gains in my view by use of PCN funds and ARR staff to increase profits thereby worsening the GP employment crisis at some cost to quality.
Often these GP partners running these secondary APMS contracts have previously been on LMCs, ICBs or additionally act as PCN CDs where information can be gathered before the wider GP community is aware.
One quick solution would be to remove these GPs who act simply in these APMS practices primarily for financial gain in my view , ship them back to their own practices or partnerships and allow those GPs who do not currently have secure positions to either run these APMS contracts as their own or ideally to allow this disenfranchised group of GPs to take over these practices as a reversion back to GMS.
The characteristics of GPs running additional APMS contracts for profit on top of their own practices are clear to see in my opinion but uncomfortable to accept and needs to be called out .This abuse of the APMS contract system by a few GPs in my view is a further problematic area in addition to the blanket introduction of inappropriate replacements of GPs by PCNs and is additionally fuelling the current GP workforce crisis, but in this case actually caused by GPs.