Since NASGP's inception back in 1997, reporting of GP numbers both in the national and medical press have, without exception, excluded the number of locums, for the simple reason that there have been no actual head counts.
To fill this gap, NASGP went back to two basic principles. The first principle is that, in order for a doctor to practise as a GP anywhere in the UK, they must be revalidated every five years, based on successful annual appraisals in each of the five years preceding their appraisal; to do so, GPs must be practising as GPs, seeing patients.
The second principle is that, to be a practising, revalidated GP, you need to be on the GMC's GP register, which as of 25th March 2019 is 62,303 patients (in 2014, when we last analysed all the data, we arrived at a figure of 17,000 GP locums across the UK, based then on 60,630 fully licensed and registered GPs. In 2008, when we first, the same calculations yielded 15,500 locums out of a total of 57,000).
Recently however, NHS digital has started to use small surveys and voluntary reporting tools to arrive at figures much below our figures, so the GMC has for the first time looked at the various analyses and has come up with its own conclusions in it's recent "What our data tells us about general practitioners working for the NHS in England and Scotland", stating that their analysis of the data for the number of GPs working as locums in 2016 gave a 20,831 GP locum headcount (we're assuming this is for the UK as a whole, although the document itself only pertains to England and Scotland). Reassuring to know that the GMC agree with us, and even suggest an even higher number!
Here's an extract from that document, published May 2018:
"There are a range of methods used by different organisations in the UK to estimate the number of Locums and the number of locum GPs varies depending on the source consulted. For example, NHS Digital estimated a headcount of approximately 2,500 locum GPs in England in 2017. NHS National Services Scotland used a survey and found that there were 350 whole time equivalent locum and sessional GPs in general practice in Scotland in 2015. Meanwhile, in 2014 the National Association of sessional GP’s and estimated that there may have been up to 17,000 locum GPs in the UK which broadly matches the findings of this analysis."
Locum headcount vs FTE
This is very hard to know based on the available national data, but based on NASGP's experience and raw, anonymised data extrapolated from NASGP's LocumDeck invoicing software service, a typical GP locum works five sessions a week.
A smaller sample collated by NHS Digital, referenced in the GMC analysis, estimated that a headcount of 2,630 GP locums in June 2017 equated to 970 full-time equivalent GP locums.
Estimated number of sessions performed by GP locums in the UK
Based on data from LocumDeck, a typical locum is seeing 15 patients per session. So taking a figure of 10,000 FTE locums each working 46 weeks a year, we estimate GP locums to be performing 69m NHS consultations per year. Given that 609m consultations were performed in England alone in 2017-18, this figure equates to and estimated 1 in 5 consultations being performed by GP locums in the UK every year.
Since this GMC's document links direct to this very page, for completeness we've kept this article's original wording as below.
Original wording and document referred to by the GMC
We don't know how many GPs are working in the NHS, so Health Secretary Jeremy Hunt has announced at this month's RCGP conference that Health Education England HEE is going to start counting us, area by area, rather than carry on guessing. Mr Hunt also challenged Labour's policy of wanting to expand the number of salaried GPs employed by hospitals, which was at odds with NHS chief executive Simon Steven's plans for hospitals to start their own GP surgeries.
— David Roscoe (@dr26) November 26, 2014
But despite this push-me-pull-you situation, the fact remains we just don't know how many GPs we're dealing with. In 2008 the NASGP estimated that there were anything up to 15,500 GP locums in the UK, and revised this figure earlier this year to 17,000 locum GPs - all this on top of any figures the government has ever produced.
Mr Hunt has asked HEE to report back before the first spending round of the next parliament.