Part of the reason is poor manpower planning, with a disproportionate female workforce, and not enough graduate places, and part is the demographics of old age, Part is due to technology advancing faster than any states ability to pay. Part is due to the short termism of the FTTP (First past the post) electoral system which rarely commits longer than 4 years money, part is due to managers moving on in their jobs usually 2 years) well before the perverse results of their changes is evident, partly due to lack of staff feedback on the system, part due to the public being uncomfortable with looking at death and old age. But the most important (rules of the game) is the lack of leadership and truthfulness from our politicians. This has led to a change in the “Shape of the Job“, early retirement, emigration stress and part time work choices We cannot have Everything for everyone for ever… but we have to have enough staff. Caring cannot be done by machines. The recruitment crisis has been coming for years and there is no quick fix.
The pensions crisis and high workloads are partly to blame for 1,000 general practice partners leaving the NHS in the year since June last year.
The figures from NHS Digital are equivalent to about one in 20 partners — doctors based permanently at a practice that they run. The GPs blamed “overly burdensome admin”, pressured working conditions and the strict new pension rules that disproportionately penalise senior NHS staff.
Overall, the number of fully qualified GPs working in England, including locums, fell by 576 (2 per cent) in the year to June this year. The number of GP partners fell by 5.3 per cent (1,035) to 18,511.
The decline in GP partners is particularly likely to affect patients who want to see the same doctor, instead of a different one each time they visit their surgery. An NHS survey of 770,000 patients has revealed that in the first few months of this year less than half of patients were able to see their preferred doctor when they wanted to.
The doctors’ pensions crisis has been triggered by changes to tax rules that mean anybody earning about £110,000 faces a limit on how much they can pay into their pension each year.
The changes disproportionately affect GPs and hospital consultants because the complicated method by which income is calculated under the rules includes non-pensionable overtime shifts and estimated growth in the value of NHS pension pots.
Doctors say that this unfairly pushes many over the threshold and means that they are hit with large tax bills, with some doctors reporting that their bills are so high they are in effect having to pay to work.
About three quarters of GPs and consultants had cut or were planning to cut their hours to avoid being penalised under the pension rules, a survey of doctors by the British Medical Association (BMA) union found this month.
Krishna Kasaraneni, of the BMA GP committee, said: “These statistics are a stark illustration of the workforce crisis that continues to blight general practice. In the face of high workloads, punitive pension regulations and the overly burdensome admin that comes with running a practice, it is no surprise that the number of GPs, and in particular partners, is continuing to fall. This is despite repeated pledges from the government to boost numbers by thousands.”
In 2015 Jeremy Hunt, as the health secretary, promised to recruit 5,000 more GPs by 2020. But despite increases in the number of training posts and a decline in unfilled places, the latest figures show that the rate of GPs leaving the profession continues to outpace the numbers being recruited.
Martin Marshall, vice-chairman of the Royal College of GPs said: “The number of fully qualified GPs leaving the profession is concerning and reflects the harsh reality of what it’s like for family doctors working in NHS general practice, facing intense resource and workforce pressures on a daily basis.”
Professor Marshall added: “The number of full-time-equivalent, fully qualified GPs is falling and at a rising pace, so we desperately need to see more funding for the roll-out of retention schemes across the country, if we have any chance of turning this situation around.”
A Department of Health and Social Care official said: “GPs are the bedrock of the NHS and we’re backing them with an extra £4.5 billion a year by 2023-24. Last year a record 3,473 doctors were recruited into GP training and we’re funding 20,000 more staff in GP practices. We are also making it easier for GPs to better balance their pensions so they can spend more time with their patients, without facing significant tax bills.”
It’s the shape of the GP’s job that needs to change. The pharmacist will see you now: overstretched GPs get help…The fundamental ideology of the Health Services’ provision. Funding of this type admits 30 years’ manpower planning failure
“Serious risk of collapse”. The BMA represents the majority of consultants and GPs thoughts, and not the Royal College of GPs (RCGP). We ALL need to worry. Its going to get worse, until we face up to reality.