Last reviewed 23 August 2021

A University of Cambridge study has found that GP practices based in deprived areas have significantly fewer full time-equivalent (FTE) GPs per 10,000 patients than those based in more affluent areas.

The study found that the inequality had also widened somewhat over time. 

The report, Inequalities in the Distribution of the General Practice Workforce in England, published in the BJGP, examined recent trends in general practice workforce inequalities using quarterly General Practice Workforce datasets from 2015 to 2020 in England.

The abstract said inequalities in general practice workforce distribution have not been examined in recent years, and previous research “found that workforce inequalities are associated with health outcome inequalities”.

The most deprived areas had 1.4 fewer FTE GPs per 10,000 patients compared to the least deprived areas by December 2020, with the picture mirrored for non-nurse practice staff.

The report also said there were 1.5 fewer patient-facing general practice staff, excluding GPs and nurses, per 10,000 patients in the most deprived areas compared to the least deprived areas.

It did say, though, that the lower number of GPs may be compensated in part by the practices having more nurses.

The research team also published an interactive dashboard that shows local-level primary care workforce inequalities. Badly affected areas include West, North and East Cumbria, Humber, Coast and Vale, and Coventry and Warwickshire STP areas. 

The report referred to previous research that suggested the reason for the inequality was the opening and closing of practices in more disadvantaged areas, with practice closures increasing in recent years.

The study concluded that policy solutions are “urgently needed” to ensure an equitably distributed workforce and reduce health inequities.

The researchers suggested options for how the trend can be reversed including increased recruitment to medical school from disadvantaged areas; enhanced training offers for these roles; incentivisation of direct patient care posts in under-staffed areas; and offering practices and networks in under-staffed areas additional recruitment support.

Royal College of GPs (RCGP) Chair Professor Martin Marshall said the RCGP “has been calling on the Government to urgently deliver on its manifesto pledge of 6000 additional GPs by 2024”. He said GPs are preparing for an exceptionally busy autumn and winter, with the expanded flu vaccination programme, Covid-19 booster campaign and a backlog from the pandemic. He added: “It is more essential than ever that general practice has the workforce capacity to manage both new and existing pressures, so that GPs can continue to deliver high-quality care to patients, wherever they happen to live.”