Counting general practitioners: a comparative repeat cross-sectional analysis of GPs in NHS general practice in England.

BACKGROUND: There have been successive government promises to increase general practitioner (GP) numbers in England. AIM: To compare how NHS general practice GP numbers and trends differ depending on how GPs are defined and data are analysed. DESIGN AND SETTING: This was a comparative repeat cross-sectional study of NHS general practice GP numbers in England. METHOD: The study compared NHS England's General Practice Workforce GP data quarterly between September 2015 and September 2024 by headcount and full-time equivalent (FTE); with and without general practice trainees; and relative to population size. RESULTS: Between September 2015 and September 2024, if counting fully qualified GPs and general practice trainees, there was an 18% (41 193 to 48 758) rise in numbers; whereas if fully qualified FTE GPs alone were counted there was a 5% reduction (29 364 to 27 966). Once growth of the population registered with an NHS general practice was considered, the trend in GPs per capita varied between a 6% rise or 15% reduction. There was an increasing difference in the number of patients per GP between practices, with a 5th to 95th percentile range of 1204 and 4139 patients per fully qualified FTE GP in 2015; by 2024 these percentiles increased to 1357 and 5559. Using Office for National Statistics (ONS) mid-year population estimates produced different results as their population estimates are lower than the total number of patients registered with an NHS general practice. CONCLUSION: How GPs are defined, whether working hours are considered, and what measure of population size is used affects the interpretation of workforce trends. Using fully qualified FTE GPs per capita most closely reflects GP capacity, although there are limitations to current NHS data. Reporting the spread of patients per GP at practice level is necessary to capture the widening variation in GP provision in England.