Most of the contact that people have with the NHS is with general practice: there are an estimated 300 million appointments each year. These services provide the first step in diagnosing and treating most patients’ health conditions.
Due to changes in the data, trends in general practice staff are limited to 2015 at the earliest. The data do not include staff working in prisons, army bases, educational establishments, specialist care centres including drug rehabilitation centres and walk-in centres. From July 2019, primary care networks (PCNs) will offer services to patients and employ new specialist staff such as clinical pharmacists, social prescribing link workers, physiotherapists, physician associates and paramedics. NHS Digital has started to publish information on the PCN workforce, but the data does not presently cover all PCNs. Based on the PCN data that is available, we have estimated the number of certain primary care staff groups employed by PCNs across England in some of the charts below.
Since 2015, the number of permanent, fully qualified GPs has fallen by around 2,200. Even when including our estimate of the GP workforce registered with PCNs, there is still a decrease of 1,800 full-time equivalent GPs. We would have expected levels to increase to be on course to deliver 5,000 more GPs as soon as possible.
About the target: The GP Forward View (2016) stated that GP staffing would be expanded to create an extra 5,000 doctors working in general practice by 2020. The Interim NHS People Plan (2019) then superseded this and called for 5,000 more GPs “as soon as possible”. The Conservative Party Manifesto has more recently committed to 6,000 more doctors in general practice by 2024/25. It is not clear whether GP registrars or locums are supposed to be counted, and whether the pledge relates to headcount or FTE.
GPs themselves make up only a minority of the total practice workforce. The total number of health professionals (excluding GPs) has increased by over 1,000 in the last year and, when including non-clinical staff, numbers have increased by over 3,100 .
About the target: The GP Forward View (2016) called for 5,000 more staff working in general practice by 2020 and for 20,000 more health professionals (excluding GPs) by 2023/24. It was not clear whether the targets related to headcount or FTE.
The number of GPs has decreased across all regions of England. Between March 2019 and March 2020, the smallest percentage decrease was in South London (-1.0%) compared to a 5.2% decrease in the East of England.
Growing the number of physician associates and clinical pharmacists in general practice have been national priorities in recent years. Since 2016, the number of clinical pharmacists has grown by a little over 900 – below the level likely needed to meet the target. Over the same period, the number of physician associates has increased by only 280, which is well below the level required to meet the ambition of 1,000 by 2020.
Despite this, we recognise that both of these professions are likely to be registered to primary care networks as their place of work, rather than general practice. Using our estimates based on PCN workforce data, it appears as though both staff groups have well exceeded their respective targets to be achieved by the end of 2020.
About the target: Targets for 1,500 more pharmacists and 1,000 physician associates in primary care by 2020 were detailed in the GP Forward View (2016). It was not clear whether the targets related to headcount or FTE.