Four out of five integrated care boards (ICBs) in England would need to at least double their number of general practitioners (GPs) to meet patient safety staffing standards, according to an analysis published by The BMJ. The British Medical Association (BMA) recommends that by 2040 there should be one full-time equivalent (FTE) GP for every 1,000 patients in England to ensure manageable workloads and patient safety.
However, recently released data show that none of the 42 ICBs in England currently meets this standard. Nationally, there is only one FTE GP for every 2,220 patients. Some regions are facing even higher ratios, such as London and Bedfordshire, Luton and Milton Keynes, where each GP is responsible for more than 2,700 patients.
Katie Bramall, chair of the BMA's GP Committee, said: "No matter where a patient lives in England, the safe limit for patients is being exceeded, with patient demand far outstripping GP capacity."
Victoria Tzortziou Brown, chair of the Royal College of GPs, commented on the findings: "The pressures on general practice are clearly far beyond what is safe or sustainable." She also noted that the disparities between ICBs were particularly concerning: "We know that areas facing higher deprivation often have the highest ratios of patients to GPs, as well as the most difficulty recruiting and retaining GPs."
A spokesperson from the Department of Health and Social Care (DHSC) responded by highlighting government efforts: "We currently have the highest number of fully qualified GPs since at least 2015 thanks to actions taken by this government." Despite this increase—648 more FTE GPs over six years—the number of registered patients has grown by about 3.7 million during the same period. This means a 6% rise in patient numbers compared with a 2% increase in GPs.
The gap between regions with the most and least stretched GP services has changed little since 2019. A spokesperson for Bedfordshire, Luton and Milton Keynes ICB said: "We presently have over 140 GPs in training roles, many of whom we expect to contribute to improving our GP to patient ratio when they qualify." However, they acknowledged that low vacancy rates could make it difficult for trainees to find positions once qualified.
The current situation reveals a paradox within workforce planning: while some qualified GPs struggle to find employment opportunities, existing staff face increasing workloads due to rising patient lists.
According to DHSC figures, more than 2,000 extra GPs were recruited last year. Health and social care secretary Wes Streeting has pledged further expansion of training numbers. However, competition remains high; in 2025 there were nearly five applicants per available specialty training post—a significant increase from previous years.
Despite ongoing workforce challenges, monthly GP appointments rose by over ten million between December 2018 and December 2025.
The DHSC spokesperson added that GPs are central to a shift from hospital-based care toward community health services and will receive increased NHS funding as part of this strategy.
Tzortziou Brown called for concrete action behind recent promises: "General practice is the bedrock of the NHS," she said. "With the right investment and meaningful initiatives to recruit and retain GPs we can turn this around and ensure patients get the care they need, when they need it, wherever they live."
