| Title |
The potential impact of Brexit and immigration policies on the GP workforce in England: a cross-sectional observational study of GP qualification region and the characteristics of the areas and population they served in September 2016
|
|---|---|
| Published in |
BMC Medicine, November 2017
|
| DOI | 10.1186/s12916-017-0953-y |
| Pubmed ID | |
| Authors |
Aneez Esmail, Maria Panagioti, Evangelos Kontopantelis |
| Abstract |
The UK is dependent on international doctors, with a greater proportion of non-UK qualified doctors working in its universal health care system than in any other European country, except Ireland and Norway. The terms of the UK exit from the European Union can reduce the ability of European Economic Area (EEA) qualified doctors to work in the UK, while new visa requirements will significantly restrict the influx of non-EEA doctors. We aimed to explore the implications of policy restrictions on immigration, by regionally and spatially describing the characteristics of general practitioners (GPs) by region of medical qualification and the characteristics of the populations they serve. This is a cross-sectional study on 37,792 of 41,865 GPs in England, as of 30 September 2016. The study involved age, sex, full-time equivalent (FTE), country and region of qualification and geography (organisational regions) of individual GPs. Additionally at the practice and geography levels, we studied patient list size by age groups, average patient location deprivation, the overall morbidity as measured by the Quality and Outcomes Framework (QOF) and the average payment made to primary care per patient. Non-UK qualified GPs comprised 21.1% of the total numbers of GPs, with the largest percentage observed in East England (29.8%). Compared to UK qualified GPs, EEA and elsewhere qualified GPs had higher FTE (medians were 0.80, 0.89 and 0.93, respectively) and worked in practices with higher median patient location deprivation (18.3, 22.5 and 25.2, respectively). Practices with high percentages of EEA and elsewhere qualified GPs served patients who resided in more deprived areas, had lower GP-to-patient ratios and lower GP-to-cumulative QOF register ratios. A decrease in pay as the percentage of elsewhere qualified GPs increased was observed; a 10% increase in elsewhere qualified GPs was linked to a £1 decrease (95% confidence interval 0.5-1.4) in average pay per patient. A large percentage of the UK general practice workforce consists of non-UK qualified GPs who work longer hours, are older and serve a larger number of patients in more deprived areas. Following Brexit, difficulties in replacing this valuable workforce will primarily threaten the care delivery in deprived areas. |
X Demographics
The data shown below were collected from the profiles of 106 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 55 | 52% |
| Spain | 3 | 3% |
| New Zealand | 2 | 2% |
| France | 2 | 2% |
| Australia | 1 | <1% |
| Estonia | 1 | <1% |
| Venezuela, Bolivarian Republic of | 1 | <1% |
| Korea, Democratic People's Republic of | 1 | <1% |
| Singapore | 1 | <1% |
| Other | 3 | 3% |
| Unknown | 36 | 34% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 53 | 50% |
| Scientists | 35 | 33% |
| Practitioners (doctors, other healthcare professionals) | 14 | 13% |
| Science communicators (journalists, bloggers, editors) | 4 | 4% |
Mendeley readers
The data shown below were compiled from readership statistics for 60 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 60 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 12 | 20% |
| Student > Ph. D. Student | 6 | 10% |
| Student > Bachelor | 6 | 10% |
| Researcher | 4 | 7% |
| Other | 3 | 5% |
| Other | 11 | 18% |
| Unknown | 18 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 20% |
| Nursing and Health Professions | 7 | 12% |
| Social Sciences | 6 | 10% |
| Psychology | 3 | 5% |
| Unspecified | 3 | 5% |
| Other | 10 | 17% |
| Unknown | 19 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 713. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 May 2019.
All research outputs
#29,127
of 25,724,500 outputs
Outputs from BMC Medicine
#43
of 4,079 outputs
Outputs of similar age
#515
of 319,759 outputs
Outputs of similar age from BMC Medicine
#1
of 48 outputs
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