BMJ Study Reveals One in Three English GPs Not Directly Working for NHS

Significant Proportion of GPs Operating Outside NHS General Practice

A new study published in the British Medical Journal (BMJ) on September 17, 2025, reveals a significant and growing trend: approximately one in three General Practitioners (GPs) licensed to practice in England are not directly employed within NHS general practice. The research, titled 'Trends in the shortfall of English NHS general practice doctors: repeat cross sectional study,' highlights a widening gap between the number of qualified GPs and those actively contributing to the National Health Service's primary care provision.

The study found that the proportion of licensed GPs not working in NHS general practice increased from 27% (13,492) in 2015 to 34% (19,922) in 2024 by headcount. When considering full-time equivalent (FTE) positions, the figures are even starker, rising from 41% (20,210 FTE GPs) to 52% (30,351 FTE GPs) over the same period. This means almost 20,000 GPs who could be working in the health service are 'lost' to it, despite unprecedented demand for care.

Factors Contributing to GP Disengagement

Several factors are cited as contributing to GPs moving away from direct NHS employment. These include intense pressures, burnout, and poor working conditions within the NHS. Many GPs are seeking greater flexibility and potentially higher pay through roles such as locum work or private practice.

• The proportion of GPs across the UK likely to move abroad to practice medicine more than doubled from 10% in 2020 to 21% in 2024.
• Similarly, the percentage planning to work privately or increase their private work rose from 23% in 2019 to 29% in 2024.
• The study also noted that female GPs, particularly those aged 30-49, younger GPs, and those in London and the South East, are disproportionately represented among those leaving NHS general practice. The fastest decline in NHS general practice was observed among male GPs aged 50-59 years.

Implications for Patient Care and NHS Capacity

The growing discrepancy has significant implications for patient access and the overall capacity of the NHS. The number of NHS patients for each full-time equivalent GP in NHS general practice increased by 15% between 2015 and 2024. By the end of 2024, there were twice as many NHS patients for each full-time equivalent GP (2,260) than for each NHS consultant (1,092).

Professor Kamila Hawthorne, Chairwoman of the Royal College of GPs, emphasized the urgent need for 'thousands more GPs' and genuine efforts to retain them, stating that new recruits are 'pouring into a leaking bucket'. Katie Bramall, Chairwoman of the British Medical Association's GP committee, described the situation as a 'significant loss of talent and capacity' and a 'brain drain'. The financial cost of training these GPs who are not working in the NHS is estimated at £8.6 billion by headcount and £13.1 billion by full-time equivalent. The Department of Health and Social Care, while not directly commenting on the study's findings, highlighted efforts to recruit over 2,000 extra GPs in the past year and a record £1 billion boost to primary care.