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. 1998 Mar;48(428):1070–1072.

General practitioner turnover and migration in England 1990-94.

D H Taylor Jr 1, B Leese 1
PMCID: PMC1410007  PMID: 9624750

Abstract

BACKGROUND: In tandem with fears about a GP workforce crisis, increasing attention is being focused on the supply and distribution of primary care services: on general practitioners in particular. Differential turnover and migration across health authority boundaries could lead to a maldistribution of GPs, yet comprehensive studies of GP turnover are non-existent. AIM: To quantify general practitioner (GP) turnover and migration in England from 1990 to 1994. METHOD: Yearly data from 1 October 1990 to 1 October 1994 were collected on GPs in England practising full time, including average yearly turnover, rates of entry to and exit from general practice, and net migration among GPs. All were calculated at the family health service authority (now the new health authorities) level. RESULTS: Average yearly GP turnover ranges from 2.9% in Shropshire to 7.8% in Kensington, Chelsea and Westminster; turnover is associated with deprivation and high-need areas. Migration of GPs across health authority borders was rare. Entry and exit rates were also positively related to measures of deprivation and need. Relatively underprovided health authorities lost 23 GPs over the study period as a result of migration; relatively overprovided ones gained three. CONCLUSION: Turnover is driven primarily by exits from general practice and is related to deprivation and high need. Retention appears to be the main problem in ensuring an adequate GP supply in relatively deprived and underprovided health authorities.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barnett J. R. How long do general practitioners remain in any one location?: Regional and urban size variations in the turnover of foreign and New Zealand doctors in general practice, 1976-90. N Z Med J. 1992 May 13;105(933):169–171. [PubMed] [Google Scholar]
  2. Benzeval M., Judge K. Access to health care in England: continuing inequalities in the distribution of GPs. J Public Health Med. 1996 Mar;18(1):33–40. doi: 10.1093/oxfordjournals.pubmed.a024459. [DOI] [PubMed] [Google Scholar]
  3. Carr-Hill R. A., Rice N., Roland M. Socioeconomic determinants of rates of consultation in general practice based on fourth national morbidity survey of general practices. BMJ. 1996 Apr 20;312(7037):1008–1012. doi: 10.1136/bmj.312.7037.1008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cavanagh S. J. Nursing turnover: literature review and methodological critique. J Adv Nurs. 1989 Jul;14(7):587–596. doi: 10.1111/j.1365-2648.1989.tb01595.x. [DOI] [PubMed] [Google Scholar]
  5. Gray A. M., Phillips V. L. Labour turnover in the British National Health Service: a local labour market analysis. Health Policy. 1996 Jun;36(3):273–289. doi: 10.1016/0168-8510(96)00818-4. [DOI] [PubMed] [Google Scholar]
  6. Gray A. M., Phillips V. L. Turnover, age and length of service: a comparison of nurses and other staff in the National Health Service. J Adv Nurs. 1994 Apr;19(4):819–827. doi: 10.1111/j.1365-2648.1994.tb01155.x. [DOI] [PubMed] [Google Scholar]
  7. Hacking J. General practice. Weight watchers. Health Serv J. 1996 May 2;106(5501):28–30. [PubMed] [Google Scholar]
  8. Judge K., Mays N. A new approach to weighted capitation. BMJ. 1994 Oct 22;309(6961):1031–1032. doi: 10.1136/bmj.309.6961.1031. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Mays N. NHS resource allocation after the 1989 white paper: a critique of the research for the RAWP review. Community Med. 1989 Aug;11(3):173–186. doi: 10.1093/oxfordjournals.pubmed.a042466. [DOI] [PubMed] [Google Scholar]
  10. Olsen N. D. Sustaining general practice. BMJ. 1996 Mar 2;312(7030):525–526. doi: 10.1136/bmj.312.7030.525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Sheldon T. A., Smith P., Borowitz M., Martin S., Hill R. C. Attempt at deriving a formula for setting general practitioner fundholding budgets. BMJ. 1994 Oct 22;309(6961):1059–1064. doi: 10.1136/bmj.309.6961.1059. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Sibbald B., Addington-Hall J., Brenneman D., Freeling P. Counsellors in English and Welsh general practices: their nature and distribution. BMJ. 1993 Jan 2;306(6869):29–33. doi: 10.1136/bmj.306.6869.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Taylor D. H., Jr, Leese B. Recruitment, retention, and time commitment change of general practitioners in England and Wales, 1990-4: a retrospective study. BMJ. 1997 Jun 21;314(7097):1806–1810. doi: 10.1136/bmj.314.7097.1806. [DOI] [PMC free article] [PubMed] [Google Scholar]

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