General practitioner turnover and migration in England 1990-94

Area of Science:

• Primary Care Research
• Health Workforce Studies
• General Practice Management

Background:

• Growing concerns exist regarding the general practitioner (GP) workforce crisis.
• The supply and distribution of primary care services, particularly GPs, are under increased scrutiny.
• Limited comprehensive studies exist on GP turnover and its impact on service distribution.

Purpose of the Study:

• To quantify general practitioner (GP) turnover and migration patterns in England.
• To analyze GP movement across health authority boundaries between 1990 and 1994.

Main Methods:

• Utilized yearly data from October 1, 1990, to October 1, 1994, for full-time GPs in England.
• Calculated average yearly turnover, entry and exit rates, and net migration at the family health service authority level.
• Correlated GP turnover and migration with area deprivation and need indices.

Main Results:

• Average yearly GP turnover varied significantly, from 2.9% in Shropshire to 7.8% in Kensington, Chelsea, and Westminster.
• GP turnover, entry, and exit rates were positively associated with higher levels of deprivation and need.
• Migration of GPs across health authority borders was infrequent, with underprovided areas losing 23 GPs and overprovided areas gaining three.

Conclusions:

• GP turnover is primarily driven by practitioners exiting general practice.
• Turnover rates are demonstrably linked to socioeconomic deprivation and high patient need.
• Improving GP retention is crucial for maintaining adequate primary care services in deprived and underserved health authorities.