Fifth of GPs are foreign and work in poorest communities, research shows

Posted on November 16, 2017

New figures compiled by University of Manchester researchers have revealed that one fifth of practising GPs in England trained abroad and typically work in the country’s most deprived communities.

The team, based at the University’s Health eResearch Centre, say overseas GPs often support the most deprived communities, work longer hours, treat more patients, but are paid less than their UK-qualified counterparts.

Uncertainties about future immigration policy caused by Brexit could impact on the retention and replacement of foreign trained GPs – even from outside the EU – in an NHS already hit by a chronic shortage, they add.

The study, published today in BMC Medicine by BioMed Central is jointly funded by the Medical Research Council and the NIHR, reveals that 4.1% of UK GPs were trained in the EU. The figure rises to 17% for doctors trained outside the EU.

The team draw their data from more than 90% of England’s GP surgeries.

Recent figures from the Department of Health show that just 2,700 GPs were recruited in 2016, far below their target of 3,250.

Photo of the Whitworth Building at the University of Manchester

Lead author Prof. Aneez Esmail, The University of Manchester said:

“The NHS is already facing such a major GP crisis that in 2015 the Secretary of State for Health promised to increase the number of GPs by 5,000 by 2020. But given that the current workforce is ageing, it takes ten years to fully train a GP and current recruitment figures are down, it seems extremely unlikely these targets will be met. 

Overseas doctors have always been part of the solution and have provided a valuable remedy to the shortage of GPs in England, this needs to be acknowledged by policy makers and our politicians.”

Senior author Dr Evan Kontopantelis, The University of Manchester commented:

“Health services are under threat due to hardening public attitudes to immigration which have been enabled by Brexit. This may be a big blow to an already in crisis English primary care service and needs to be addressed urgently.

Foreign trained doctors are a marginalised and stigmatised group of doctors, who need proper professional support. Overseas qualified doctors should be seen as part of the solution to the GP recruitment crises – as our analysis shows they play a critical role in the delivery of NHS GP services, working in the most deprived areas but providing high quality care.”

The paper goes on to highlight the inequalities facing foreign doctors by revealing that despite achieving similar patient outcomes to their UK-trained equivalents (and after adjusting for academic ability) foreign doctors are more likely to fail postgraduate exams and be disciplined by their employers.

Prof. Aneez Esmail added:

“Overseas doctors have less experience of the NHS and of UK GP training; understandably they need more time and support to prepare for exams and the delivery of UK primary care services.  Unfortunately, GP training time is restricted by the GMC and the RCGP meaning non-UK qualified doctors face an uphill struggle from the outset.
Rather than tightening immigration policy the Department of Health should do more to support and harness international talent in alleviating the growing GP crisis.”

The team urge the Government to see overseas-qualified doctors as part of the solution to the GP recruitment crisis.