ArticleBMJ open2024
The changing shape of English general practice: a retrospective longitudinal study using national datasets describing trends in organisational structure, workforce and recorded appointments.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Continuity of care in UK primary care: a scoping review of measures, challenges, and future interventions.Primary health care research & development · 2026Article
- Counting general practitioners: a comparative repeat cross-sectional analysis of GPs in NHS general practice in England.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Winter pressures in general practice in England.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Management of hidradenitis suppurativa in UK primary care: a cross-sectional survey.BJGP open · 2025Article
- From hospital to community? The good, the bad, and the ugly of the 10-year plan to move care to the community.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Incentivising general practice: a review of the Scottish targeted enhanced recruitment scheme (TERS) through recruitment and training data.BJGP open · 2025Article
- Trends in the shortfall of English NHS general practice doctors: repeat cross sectional study.BMJ (Clinical research ed.) · 2025Article
- Improving Diabetes Monitoring in People with Sub-optimally Controlled Diabetes: Implementing a Clinical Laboratory-Led Quality Improvement Initiative in General Practice.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Article
- CICing the partnership model into the future: a new social enterprise model for general practice?The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- General practice characteristics associated with pay-for-performance in the UK: a systematic review.BJGP open · 2025Article
- The relationship between general practice characteristics, case-mix, and secondary care attendances/admissions before and after the COVID-19 pandemic: Protocol for an OpenSAFELY cohort study.Wellcome open research · 2025Article
- Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe trends in the organisational structure, workforce and recorded appointments by role in English general practice.
designRetrospective longitudinal study.
settingEnglish general practice. DATA SOURCES AND
participantsNHS England, Office for Health Improvement and Disparities and Care Quality Commission national administrative datasets covering between 5 to 10 years from 2013 to 2023.
resultsBetween 2013 and 2023, the number of general practices fell by 20% from 8044 to 6419; the average practice list size increase by 40% from 6967 to 9724 patients. The total population covered by providers with over 100 000 registered patients reached 2.3 million in 2023 compared to 0.5 million in 2017. The proportion of practices under individual ownership decreased from 13% to 11% between 2018 and 2023; there was little change in the proportion owned by partnerships, incorporated companies or NHS bodies, which respectively averaged around 80.3%, 6.9% and 0.7%. Between 2015 and 2022, there was a 20% rise in the total full-time equivalent (FTE) general practice workforce, including Primary Care Network staff, from 1.97 to 2.37 per 1000 patients because of an increase in multidisciplinary other 'Direct Patient Care' (DPC) and administrative roles. The number of nurses remained stable, and the number of qualified general practitioners (GPs) decreased by 15%. In September 2022, there were 0.45 FTE qualified GPs per 1000 patients; GPs and other DPC roles, excluding nurses, each represented 19% of the FTE per 1000 patients workforce; administrative roles represented 51%. The general practice workforce is predominantly female. A quarter of GPs qualified overseas. Between 2018 and 2023, there was no clear upward or downward trend in total appointments per 1000 patients with, on average, half provided by GPs.
conclusionsSince 2013, there has been a shift in general practice towards larger practices with more multidisciplinary teams, alongside a reduction in the number of FTE qualified GPs per 1000 patients. We recommend that the impacts of these changes on access, quality and costs are closely monitored.
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