More than one in 10 family doctor roles in England are vacant – with many practices increasingly having to rely on locum doctors to deliver patient care, according to new research by the Royal College of GPs.
An RCGP survey of 549 practices in England found that 10.2% of full time equivalent positions are vacant – 61% of which are currently filled by locum or agency staff.
Of the practices surveyed, 64% reported that finding enough locum doctors to meet growing patient demand was either difficult or very difficult. Just 8% reported that this was easy.
The findings also cast doubt on the feasibility of government plans to introduce a seven-day working week in general practice, which would involve stretching current resources even further.
The College is calling on the government and NHS England to concentrate its efforts on strengthening the GP workforce to ensure that the current five-day service is robust and is complemented by better supported, better integrated, and better publicised out of hours GP services.
Currently, only 45% of patients know how to access out of hours GP services, according to the latest GP Patient Survey, conducted by Ipsos Mori on behalf of NHS England.
The College is also calling for steps to be taken to promote practice-based working as a secure and satisfying career for doctors entering the profession.
The College says that locum GPs play a key role in providing patient care. However, the College believes it is a matter of concern that so many full time equivalent GP posts are vacant at practices across the country.
Locum GPs are family doctors who are not tied to a particular practice – they stand in for permanent GPs when they are ill, on holiday, or to fill a temporary vacant post. However, recent trends have shown an increase in locums being used on a permanent basis when practices are unable to recruit.
The government has pledged to create 5,000 more GPs over the course of this parliament – and Health Education England has a target to ensure that half of all medical students choose to specialise in general practice.
However, the College estimates that around 3,300 additional GPs are needed now – just to meet current demand – without taking into account growing patient demand over the next five years, and those GPs who will leave the profession due to retirement. The College believes that England will need 8,000 additional GPs by 2020 to provide existing five day and OOH services for the changing needs of the population.
GPs and their teams currently make 370m patient consultations every year – 60m more than five years ago and the equivalent of 150,000 extra consultations being delivered every day.
But whilst workload has rocketed – due to a growing and ageing population – the GP workforce has remained relatively stagnant, and the share of the NHS budget that general practice receives has dropped year on year to a record-low 8.4% in England.
Chair of the RCGP Dr Maureen Baker said: “We are in dire straits if we do not act to address the GP recruitment crisis immediately and ensure that there are enough GPs in the system so that practices do not have to run with a substantial number of vacant positions.
“Our new research brings home how difficult GP practices are finding it to recruit new doctors and retain existing ones. It is simply unrealistic to be thinking about seven-day working when our existing five-day service and out of hours GP services are under so much pressure.
“Many GP services are already offering extended hours. However, opening for extended periods is pie-in-the-sky for many family doctors who are already working exceptionally long hours in clinic to cope with demand.
“Locum doctors do an excellent job, and provide an essential service for patients. Working as a locum can also be a productive career path, particularly for young GPs, as it gives them a wide experience of the diverse challenges of general practice.
“But the government and NHS England must ensure that the pendulum swings such, so that practice-based work is always seen as the main career choice for most GPs.
She added: “The government needs to move away from its obsession with ‘providing a seven day NHS’ and do more to implement the joint 10-point plan to build the GP workforce and ‘recruit retain and return’ thousands more GPs as soon as possible, so that we can provide a good, solid and safe five-day service, and out of hours service, for our patients.
“Routine seven-day working may improve patient safety in hospitals but in general practice it could have the opposite effect.”
The College’s research was based on an online survey with more than 1,200 of its members, during August, which were representative of 549 practices in England.
RCGP Press office: 020 3188 7574/7575/7581
Out of hours: 0203 188 7659
Notes to editor
The Royal College of General Practitioners is a network of more than 50,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.