One in three GPs with a licence to practise in England have never worked in the NHS or have left the service, data suggests.
Analysis also shows that the number of NHS patients for every GP has increased by 15% in the last decade.
Experts said there were several reasons why GPs are not working in the NHS, including funding issues that mean some are unable to find jobs, while others leave due to burnout and poor working conditions.
The difference in 2024 was particularly pronounced among female GPs, those who were younger, and for GPs in London and the South East.
The analysis of data, published in the British Medical Journal (BMJ), found that, on average, for every five additional GPs licensed by the General Medical Council (GMC), NHS general practice lost one full-time equivalent GP each year for the period 2015 to 2024.
As a result, 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, and from 41% (20,210) to 52% (30,351) by full-time equivalent GPs.
Taking population growth into account, the number of NHS patients for each full-time equivalent GP in NHS general practice increased by 15%, whereas the number of patients for each full-time equivalent NHS consultant fell by 18%, the study showed.
By the end of 2024, there were twice as many NHS patients for each full-time equivalent GP in NHS general practice (2,260) than for each full-time equivalent NHS consultant (1,092).
Professor Kamila Hawthorne, chairwoman of the Royal College of GPs, said: “This study shows there is no doubt about it, we need thousands more GPs – and we need to see genuine efforts to keep them working in the NHS, delivering patient care.
“In England, a fully qualified, full-time GP is now responsible for the care of hundreds more patients than they were 10 years ago, and it’s our patients who bear the brunt when they struggle to access our services.
“But despite the increasing patient need for GP care, cash-strapped practices are struggling to fund the GP roles necessary to deliver it – and many members are reporting difficulties finding appropriate work upon qualification as a result.
“GPs from overseas, upon completion of GP training in the UK, also report difficulties securing visas to work in NHS general practice.
“With the intense workload and workforce pressures GPs and our teams are currently working under – caused by years of underfunding and poor workforce planning – burnout is also a considerable problem, with many members telling us they plan to leave the workforce earlier than planned due to stress and unmanageable workloads.
“The Health Secretary has made welcome commitments to support general practice and deliver thousands more GPs, but we need to see just as much focus on retaining the GPs we have in the profession, as recruiting more.
“We look to the forthcoming review of the NHS Long Term Workforce Plan to see how this will be addressed.
“We also want to see GPs from overseas, who have completed GP training in the UK, being given the right to apply for indefinite leave to remain, so they can work in NHS general practice without jumping through hoops.”
In the study, researchers said the general practice workforce has become “increasingly reliant on female GPs and GPs aged 40-49”.
They added: “The discrepancy between the number of GMC-licensed and NHS general practice GPs was greater for women than men. By age band, the greatest difference was in those aged 30-39 years by headcount, with a trend suggesting that most newly qualified GPs are not entering the NHS general practice workforce or leaving within the first 10 years.
“The fastest rate of decline in NHS general practice was seen in male GPs aged 50-59 years.”
Katie Bramall, chairwoman of the British Medical Association’s GP committee, said: “The fact that a third of licensed GPs in England are not working in NHS general practice represents a significant loss of talent and capacity at a time when each GP in England looks after over 2,000 patients.
“GPs across England already deliver an unprecedented 1.42 million appointments a day, yet demand continues to grow.
“We simply cannot afford the brain drain and loss of potential these GPs represent.
“The public’s number one health priority is general practice so the Government must heed our proposed solutions to fund more GP roles to deliver more appointments to more patients, lest the crippling workload drive away more colleagues.
“It is crazy that we have GPs, ready to work and serve their communities, with too few NHS roles available.”
Earlier this month, the RCGP wrote to Home Secretary Shabana Mahmood to ask for a meeting to discuss barriers to GPs securing visas to work in the UK.
The letter said: “While the Government has committed to a long-term plan to expand medical school places and rely less on immigration, in the short to medium term the NHS would fall apart without GPs who are originally from outside the UK.”
A Department of Health and Social Care (DHSC) spokesman said: “We are making progress to reverse more than a decade of neglect in primary care – recruiting more than 2,000 extra GPs in the past year, delivering a record £1 billion boost and funding vital upgrades to surgeries, as well as cutting red tape so doctors can spend more time caring for patients.
“July 2025 saw the highest ever headcount of fully qualified GPs and patient satisfaction with GP services is rising.
“We are putting GPs at the heart of our shift to neighbourhood health services as part of our 10-year health plan.”
DHSC said July 2025 recorded the highest ever headcount number of fully qualified GPs (38,960).
