The NHS is currently facing a significant crisis, particularly in the realm of general practice, where pressures have led to an alarming trend: surgeries are increasingly hiring non-doctors for roles traditionally filled by GPs. The government’s decision to allocate £1.4 billion for non-doctor positions, such as physician associates, has exacerbated the situation, making it difficult for locum GPs to find work. This shift has resulted in experienced locum GPs losing their positions almost overnight, leaving many without opportunities after years of service in the field.
Despite promises to recruit 6,000 new GPs by 2024, the government has failed to deliver on this commitment. Nearly half of all appointments in GP practices are now conducted by non-GP staff, which has financial benefits for surgeries but undermines the role of qualified doctors. This has created intense competition for salaried GP roles, with reports indicating that there are between 40 to 60 applicants for each position, making it increasingly challenging for qualified GPs to secure stable employment.
A recent survey revealed a 44% decline in advertised GP vacancies since November 2022. Additionally, the number of ad hoc locums providing temporary cover in England has dropped significantly, from 2,511 in March 2023 to just 1,624 in March 2024—a striking 35% decrease. The British Medical Association (BMA) has termed this an “employment crisis,” attributing it to reduced funding for general practice. The Additional Roles Scheme (ARRS), introduced in 2019, has further complicated matters by creating 18 new roles in primary care that do not include doctors, leading to a 90% drop in locum bookings, according to recruitment consultants. Many GPs are now resorting to seeking employment in hospitals, reflecting a desperate need for job security and better working conditions.
Kamila Hawthorne, chair of the Royal College of GPs, has criticized the ARRS for diverting attention from the need to hire more GPs, emphasizing that general practice has suffered from decades of neglect and underfunding. She expressed frustration over the struggles faced by GPs in securing vacancies amidst growing demand for care, highlighting the disconnect between government promises and the reality on the ground.
An NHS spokesperson countered these concerns by stating that the organization is training more GPs, with an increase of 807 fully qualified GPs reported recently. The NHS plans to boost GP training places by 50% by 2031-32, suggesting that the additional primary care roles should support GPs rather than replace them. However, many healthcare professionals remain skeptical about these claims, given the current staffing shortages and the increasing reliance on non-doctor roles.
Despite government assurances of improvement, the reality is that the NHS is increasingly staffed by underqualified personnel, which could compromise patient care. Many patients have lost faith in GP practices, with numerous appointments now handled by individuals who lack proper medical qualifications. This trend raises serious concerns about the quality of care patients can expect from the NHS moving forward.
The ongoing issues within the NHS highlight the urgent need for a reevaluation of workforce planning and funding strategies to ensure that qualified doctors are not displaced and that patients receive the high-quality care they deserve. The government must take decisive action to address these challenges, restoring confidence in the NHS and ensuring that it can meet the growing healthcare needs of the population effectively. Without significant reforms and increased investment, the future of general practice in the UK remains uncertain, with potential long-term implications for patient health outcomes and the overall sustainability of the NHS.
Moreover, the increasing reliance on non-doctor roles may lead to a dilution of the standards of care that patients have come to expect. As the NHS grapples with these challenges, it is essential to foster a collaborative environment where both GPs and non-doctor roles can coexist, ensuring that patient safety and care quality are prioritized. Training programs should be expanded, not only for GPs but also for non-doctor roles, to ensure that all staff members are equipped with the necessary skills and knowledge to provide effective care. By investing in the workforce comprehensively, the NHS can better adapt to the evolving healthcare landscape and address the pressing needs of its patients.
Furthermore, engaging with frontline healthcare professionals to gather insights and feedback can help shape policies that truly reflect the needs of the workforce and the patients they serve. This collaborative approach could lead to innovative solutions that enhance job satisfaction for GPs and improve the overall efficiency of the healthcare system. By prioritizing both the recruitment of qualified staff and the support of existing personnel, the NHS can work towards a more sustainable and effective healthcare model that benefits everyone involved.
