Government plans to improve patients'
ability to see their GP are at risk due to a dramatic fall in the
number of GP partners, new analysis reveals today.
The Nuffield Trust shows that, after
years of steady decline, GP partners are now in a minority among
fully qualified GPs. Meanwhile, the number of GP surgeries has
dropped by a fifth in 10 years and the number of GP partners
under the age of 40 has plummeted by 53% since September
2015.
The think tank says this raises
serious questions about the sustainability of the traditional
partnership model of general practice in operation since 1948,
whereby GP partners operate as self-employed contractors bearing
both the risk and reward of their partnership's
performance.
In a policy paper aimed at shaping the
government's promised reforms to general practice, the Nuffield
Trust calls on policymakers to proactively develop and test
alternatives to the partnership model, alongside measures to
shore it up in areas where it is working well.
The paper comes just days after a new
contract has been agreed by the government and the GP profession,
with plans afoot for further reform as part of the longer-term
contract negotiations about to begin.
Options for reform discussed in the
paper range from expanding existing alternatives to partnership
(such as hospitals running GP surgeries, or turning partnerships
into employee-owned trusts) to more radical new models – such as
creating new NHS-run organisations to deliver general practice
and offer salaried NHS employment to multidisciplinary GP
teams.
Key findings from the Nuffield Trust
paper include:
-
The number of GP partners has
dropped by almost 25% since 2015, from 24,491 in September
2015 to 18,425 in December 2024. In June 2024 GP partners
were in a minority among fully qualified GPs for the first
time.
-
Over the same time period, the
number of salaried GPs has increased by 81% – from 10,270 in
September 2015 to 18,557 in December
2024.
-
The number of GP partners aged
under 40 has fallen by 53% from 4,676 in September 2015 to
2,210 in December 2024. The only age group with growth in
partner numbers is the over 60s, which grew from 2,429 in
September 2015 to 2,662 in December
2024.
Proactively looking at alternatives to
the partnership model would be a departure from the current
approach, which has been to allow different models of general
practice to spring up without top-down direction from the
government, whilst the partnership model has withered in many
areas. The Nuffield Trust says that the consequences of this
approach mean that the provision of general practice in local
areas is threatened.
Commenting on the paper, Dr
Becks Fisher, Director of Research and Policy at the Nuffield
Trust said:
“The model of general practice that we
have relied upon for the past 75 years is declining. For reasons
that aren't going to change any time soon, many younger GPs are
simply not in a position to take on the risk and workload
associated with GP partnership.
“Alternatives are desperately needed,
but the answer is not for the government to simply abolish the
partnership model. Rash moves could dangerously destabilise
general practice and undermine provision in areas where
partnership is working well.
“Nor is inaction an option: letting
the current model continue to wither is likely to result in more
practices closing their doors, with disastrous consequences for
patients. Instead, we need a strategy that restores the core
functions of general practice and supports whatever models sit
behind that – sometimes partnership, sometimes other models. This
will mean careful planning and evaluation from the government,
working hand in hand with the profession and learning from what
is working in different parts of the
country.”
Ends.
Notes to Editors
