Just over a third of licensed GPs in the UK did not work for the NHS in 2024, up from around a quarter in 2015, according to a BMJ study.

The study found that for every five new GPs who received a General Medical Council (GMC) licence between 2015 and 2024, the NHS gained one new GP in general practice and lost one full-time equivalent GP — a measure of workload. 

Meanwhile, the number of patients registered with NHS general practices rose by 11% between 2016 and 2024. 

“The previous UK government hoped that increasing recruitment for other roles involving direct patient care in general practice would offset the decline in GP participation and tackle problems with access to care,” wrote Becks Fisher, director of research and policy at the Nuffield Trust, in a BMJ editorial. 

“However, despite more than 40,000 staff being recruited to these roles in England since 2019 (including pharmacists, physiotherapists, paramedics, and link workers) patients are adamant that it is GPs they want to see,” she added. 

Underlying Reasons

Earlier studies identified multiple reasons for GPs leaving NHS general practice or reducing hours. These include retirement, burnout, dissatisfaction with the role or NHS culture, financial reasons, a desire to move abroad, and pension concerns.

The BMJ study also highlighted a shrinking proportion of GMC-licensed GPs aged 30-39. The researchers said this is particularly concerning as the future of NHS general practice relies on this group.

They recommended examining the pull factors of alternative careers, collecting data on what GPs do outside NHS roles, and analysing whether higher income leads to reduced working hours.

“We suggest that the GMC considers collecting and publishing information about the type and quantity of work undertaken by GPs as part of the annual retention fee process or by annual surveys,” they wrote. 

Barriers to Entry 

Barriers to entering NHS general practice also remain. Recent reports have indicated that some GPs cannot find work in NHS practices despite shortages, according to the researchers. 

Work visa restrictions compound the issue for international graduates, who made up 52% of GP trainees in August 2024, said Professor Kamila Hawthorne, chairwoman of the Royal College of GPs, in the Independent. 

Fisher noted that the “tide may be turning,” with data showing that the number of full-time equivalent fully qualified GPs has risen since January 2025. 

“While policy makers may argue that little can be done to control competing job options for GPs outside the NHS, ending the paradox of GPs being unable to get NHS work when more GPs are desperately needed must be prioritised,” Fisher wrote.

She added that ensuring jobs exist for newly trained GPs is only one part of the solution. 

“The complex mix of factors driving one in three qualified GPs out of NHS general practice must be addressed together,” she said. 

Annie Lennon is a medical journalist. Her writing appears on Medscape, WebMD, and Medical News Today, among other outlets.