BMA locum leader: ‘GP unemployment is unacceptable and bizarre’

Dr Mark Steggles, chair of the BMA’s sessional GP committee , considers the impact of the GP workforce crisis as the BMA launches a survey on under and unemployment

It is incomprehensible that, at a time of immense pressure on the health service, and patients waiting far too long for appointments, GPs are struggling to find employment.  

It’s an unacceptable and bizarre situation, given we’re in desperate need of more GPs to keep up with patient demand.   

And many are understandably anxious about what it means for them, their livelihoods, and, ultimately, the future of their profession.    

As Cogora’s white paper points out, there are several factors at play in this recruitment crisis, and it’s not because GPs aren’t looking for work.  

General practice doesn’t have enough core funding, operational costs have soared, the ARRS is ineffective, and often there isn’t enough space for extra staff in crumbling practice buildings.  

We know from the BMA survey last summer that many locum GPs struggle to find work. We are now seeing the same issue with all GP positions, as opportunities for partnership, salaried, and out-of-hours GP roles become fewer and more competitive. 

When we got the results of the locum survey, we warned the Government that without intervention the situation would worsen. The locums we surveyed in summer 2024 were the canaries in the coalmine.   

The Government saw there was a problem and quickly expanded the ARRS to include £82m in funding for newly qualified GPs as an emergency measure. But that’s all it can and should be – an emergency measure.  

GPs in ARRS is restrictive and, because the funding is directed to PCNs and not individual practices, it often means GPs have to uproot their lives and move to another part of the country to find work.  

That means turning their lives upside down for what is often just a fixed term role – something which also affects patients because it doesn’t guarantee continuity of care, the top priority for the Government.

International medical graduates are at particular risk of being forced into these roles, given their visas are reliant on their employment.

What’s more, the salary reimbursement for ARRS GPs falls well below current market rates. 

The ARRS is fundamentally not fit for purpose. Limiting the type of staff practices can hire means they can’t make recruitment decisions tailored to their patients’ needs.  

Details are still under discussion as part of the 2025/26 contract negations, but the Government has confirmed that the additional GP ARRS funding will continue into 2025/26, but it’s not guaranteed indefinitely. What really needs to be done is for core funding to be increased to create practice-based opportunities for GPs. 

The additional £889m announced for general practice last December for 2025/26 is a lifeline for practices – especially with the surge in employer National Insurance contributions -but not what they need to truly flourish.  

At the same time, patient demand has skyrocketed: in December 2018, an average of 1.08 million appointments were delivered in general practice each working day. By the end of December 2024, that figure stood at 1.42 million.  

The Government needs to act, starting with lifting the restrictions around the ARRS funding, so practices have full control over who they recruit at a practice level. Then, for the long-term viability of the profession, core funding must drastically improve, and premises refurbished.   

To help us achieve this, we’ve opened a new survey – this time for all GPs affected by the issue, to help us better understand the impact under- and unemployment is having on the ground. On 12 February, the BMA will also be hosting a virtual rally to stand against the issue.  You can find out more here. 

So, we are asking GPs about their experiences; are they struggling to find work and do they even see a future in the NHS anymore?   

Tell us, and we will make it our mission to lobby Governments and bring about change.

Dr Mark Steggles is chair of the BMA’s sessional GP committee