One in three licensed GPs not working in NHS general practice, BMJ study finds
Analysis links rising share of licensed GPs outside NHS general practice to burnout, funding gaps, and shifting career choices; experts call for thousands more GPs and sustained reform.
A new BMJ analysis of General Medical Council data shows that between 2015 and 2024, about one in three GPs with a license to practice in England were not working in NHS general practice. The study highlights that younger doctors are disproportionately represented among those leaving or not entering GP work, with many moving to private practices, academia, or industry. It also notes a measurable outward shift: for every five newly licensed GPs, NHS general practice lost one full-time equivalent GP each year on average during 2015–2024.
By headcount, the share of licensed GPs not working in NHS general practice rose from 27% (13,492 GPs) in 2015 to 34% (19,922) in 2024. By full-time equivalents, the share climbed from 41% (20,210 FTEs) to 52% (30,351 FTEs) over the same period. When population growth is taken into account, the number of patients per full-time equivalent GP in NHS general practice increased by about 15%. In contrast, the number of patients per full-time equivalent NHS consultant decreased by 18%, underscoring widening gaps in primary care access.
The findings come as health chiefs face persistent concerns about access to GP services, a central tenet in NHS reforms often cited by the public as a priority. Experts say burnout, workload pressures, and funding constraints contribute to the difficulty in recruiting and retaining GPs in NHS general practice. They warn that the shift of newly qualified doctors into non-NHS roles exacerbates patient access challenges, especially as demand for GP care continues to rise.
Professor Kamila Hawthorne, chair of the Royal College of General Practitioners, said the data make clear that the NHS needs thousands more GPs and a sustained effort to retain them within the NHS. “This study shows there is no doubt about it, we need thousands more GPs—and we need to see genuine efforts to keep them working in the NHS, delivering patient care,” she said. She noted that in England, a fully qualified, full-time GP now cares for hundreds more patients than a decade ago, and many practices lack the funding to expand GP roles even as patient needs grow. Hawthorne added that forthcoming reviews of the NHS Long Term Workforce Plan should address these gaps.
Katie Bramall, chair of the British Medical Association’s GP Committee, described the statistic as a “significant loss of talent and capacity” at a time when each GP already handles more than 2,000 patients. “GPs across England already deliver an unprecedented 1.42 million appointments a day, yet demand continues to grow. We simply cannot afford the brain drain and loss of potential these GPs represent,” Bramall said. She urged Government action to fund more GP roles and expand primary care capacity so more patients can access timely appointments.
The Department of Health and Social Care responded by saying it is reversing more than a decade of neglect in primary care. A spokesperson cited efforts to recruit more than 2,000 extra GPs in the past year, a record £1 billion funding boost, and investments to upgrade surgeries and reduce bureaucratic barriers so doctors can spend more time with patients. The department also noted that July 2025 recorded the highest-ever headcount of fully qualified GPs, at 38,960, alongside rising patient satisfaction with GP services. The government framed these steps as part of a broader shift to neighbourhood health services under a 10-year plan.
The study’s authors and health leaders emphasized that the trend has implications for access to care and the overall ability of the NHS to meet rising demand. They cautioned that without a more robust primary care workforce, longer waits for GP services could intensify pressure on hospitals and other parts of the health system. As policy makers weigh the next stages of the NHS Long Term Workforce Plan, the emphasis remains on expanding GP training places, improving working conditions, and ensuring sustainable funding models that keep GPs in NHS general practice while meeting patient needs.
In 2024, the number of patients per full-time equivalent GP in NHS general practice rose to a level where a typical GP tended to oversee more patients than a decade earlier, a stark contrast to the patient loads reported for NHS consultants. The divergence underscores the central challenge of primary care capacity in England’s health system and the urgency with which policymakers must address recruitment, retention, and workload issues to restore timely access to GP services for the public.