Dh. Taylor et B. Leese, RECRUITMENT, RETENTION, AND TIME COMMITMENT CHANGE OF GENERAL-PRACTITIONERS IN ENGLAND AND WALES, 1990-4 - A RETROSPECTIVE STUDY, BMJ. British medical journal, 314(7097), 1997, pp. 1806-1810
Objectives: To describe the recruitment and retention of general pract
itioners and changes in their time commitment from 1 October 1990 to 1
October 1994. Design: Retrospective analysis of yearly data. Setting:
England and Wales. Subjects: General practitioners in unrestricted pr
actice. Main outcome measures: Numbers of general practitioners moving
into and out of general practice; proportion of general practitioners
practising less than full time; proportion of general practitioners h
aving unchanged time commitment over the study period; and proportion
of general practitioners leaving general practice in 1991 who were sub
sequently practising in 1994. Results: Numbers of general practitioner
s entering general practice (1565 in 1990, 1400 in 1994) fell over the
study period as did the numbers leaving general practice (1488 in 199
0, 1115 in 1994). The net effect was an increase in both the total and
full time equivalent general practitioners practising from 1 October
1990 (26 757 full time equivalents) to 1 October 1994 (27 063 full tim
e equivalents). Numbers of general practitioners practising full time
were decreasing whereas part time practice was increasing women were m
ore likely to practise part time. 35.5% (43/121) of women practising f
ull time and 17.8% (24/135) of men practising full time who left pract
ice in 1991 were practising again in 1994. Conclusion: Simply using to
tal numbers of general practitioners or net increase to describe workf
orce trends masks much movement in and out of general practice and bet
ween differing time commitments. Recruitment and retention issues need
to be separated if reasonable policies are to be developed to assure
the necessary general practitioner workforce for a primary care led NH
S.