Chronic shortage of family doctors in England, reveals BMJ analysis

(Press-News.org) Four fifths of England’s integrated care boards (ICBs) - responsible for planning health services for their local population - would need to at least double their number of general practitioners to meet staffing standards considered safe for patients, finds an analysis of NHS workforce data published by The BMJ today.

The British Medical Association (BMA) says that, by 2040, England should have one  full time equivalent (FTE) GP for every 1,000 patients, to ensure manageable workloads and patient safety.

But new data released last month shows that every one of England’s 42 ICBs is falling far short of meeting this safe threshold, explains Stephanie Santos Paulo.

Nationally, there is one FTE GP for every 2,220 patients, but ICB level data show some regions are facing a far more severe doctor drought than others. The highest reported patient to doctor ratios are in London, Bedfordshire, Luton and Milton Keynes, where there are more than 2,700 patients for every GP.

“No matter where a patient lives in England, the safe limit for patients is being exceeded, with patient demand far outstripping GP capacity,” said Katie Bramall, chair of the BMA’s GP Committee.

Victoria Tzortziou Brown, chair of the Royal College of GPs, added that the findings demonstrated the “troubling picture” of general practice under growing strain. “The pressures on general practice are clearly far beyond what is safe or sustainable,” she said.

But a Department of Health and Social Care (DHSC) spokesperson defended the government’s record on GP numbers, saying, “We currently have the highest number of fully qualified GPs since at least 2015 thanks to actions taken by this government.”

While it is true that England now has 648 more FTE GPs than six years ago, since then around 3.7 million more patients have been registered at GP practices. This represents a 6% rise in patient numbers, against a 2% increase in GPs, leaving practices more thinly spread.

What’s more, since 2019 the gap between the most and least stretched ICBs has hardly changed, suggesting that these workforce shortages are chronic.

Tzortziou Brown said the “stark disparities” between ICBs were worrying. “We know that areas facing higher deprivation often have the highest ratios of patients to GPs, as well as the most difficulty recruiting and retaining GPs,” she said.

A spokesperson for Bedfordshire, Luton and Milton Keynes ICB said, “We presently have over 140 GPs in training roles, many of whom we expect to contribute to improving our GP to patient ratio when they qualify.” But they acknowledged that a low number of GP vacancies could make it difficult for trainees to secure posts once they qualified.

The data underline what GP leaders describe as a paradox in the workforce crisis, with qualified GPs unable to find work while their employed counterparts struggle to keep pace with growing patient lists, writes Santos Paulo.

The DHSC says it has recruited more than 2,000 extra GPs in the past year, and health and social care secretary Wes Streeting has also pledged to expand training numbers further.

But expansion of GP training places would need to be considerable to keep up with growing demand, argues Santos Paulo. In 2025, there were 20,995 applications for 4,726 GP specialty training posts, a ratio of almost five applicants per post. This competition ratio has more than tripled since 2019, when there were just 1.34 applications per post.

She also points out that despite workforce pressures, the monthly number of GP appointments rose by more than 10 million between December 2018 and December 2025, reaching a record high last year.

The DHSC spokesperson said that GPs are “at the heart” of the government’s “historic shift” from hospital to community and will benefit from a growing share of NHS funding.

But Tzortziou Brown said the health secretary’s promises to support general practice and deliver “thousands more GPs” must be backed by a clear and robust 10 year workforce plan.

“General practice is the bedrock of the NHS,” she says. “With the right investment and meaningful initiatives to recruit and retain GPs we can turn this around and ensure patients get the care they need, when they need it, wherever they live.”

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