New study finds increase in GP turnover over past decade

A new study by researchers at the University of Manchester has found that most NHS regions have experienced a ‘steady rise in GP turnover’ over the past decade, between 2007 and 2019.

Researchers discovered that the proportion of practices with a high turnover of practitioners – defined as 10 per cent to 40 per cent within a year – ‘almost doubled’, from 14 per cent in 2009 to 27 per cent in 2019.

However, it was also noted that the number of practices with ‘very high turnover’ – above 40 per cent – remained stable at around 8 per cent.

The university says that the study chose to focus on changes in turnover – defined as ‘the number of GPs who leave a practice divided by the average of the number of GPs at the start and the number of GPs at the end of the year’ – as high turnover is considered a ‘marker of poor fiscal and organisational “health”’.

This was calculated by rates and region, using NHS data from all English general practices, of which there were 8,085 in 2007 and 6,598 in 2019.

The paper also found that practices in the most deprived areas had higher turnover rates – up to 10 per cent more – compared to those located in the least deprived areas, even when accounting for differences across NHS regions.

Other notable findings from the study were that number of practices with ‘persistent high turnover’ – at least three consecutive years – increased from 2.7 per cent in 2007 to 6.3 per cent by 2017.

While there was also regional variability in turnover, with practices in the former NHS West Midlands Strategic Health Authority reporting the largest increase and the highest levels in 2019, going from 6 per cent to 12 per cent.

Co-author of the paper, Professor Evan Kontopantelis from The University of Manchester, said: “We already know the GP workforce in England is going through a major crisis. Rates of early retirement are increasing, as are intentions to reduce hours of working or leave their practice in the near future.

“Though in 2015, the government promised 5,000 more doctors in primary care by 2020, the number of full-time equivalent GPs per 1,000 patients continues to decline.

“Quantifying GP turnover and understanding how it is distributed is fundamental to addressing challenges for the national health service, and for ensuring that quality and continuity of care are available to patients.”

He added: “We reveal worrying trends in GP turnover. High levels may affect the ability to deliver primary care services; and undermine continuity of care which in turn may affect the quality of patient care.

“And healthcare received from multiple GPs can lead to conflicting therapeutic treatments and fragmented care.

“Differential turnover across practices and regions could also lead to a maldistribution of GPs, exacerbating retention problems and health inequalities.”

The full paper, ‘Rates of turnover among general practitioners in England between 2007-2019: a retrospective study’, is published in BMJ Open and was supported by the Health Foundation through the Efficiency Research Programme.