English GPs in areas of socioeconomic deprivation endure increased job pressures related to managing complex patients, insufficient resources, and difficulty in finding locum cover, an analysis by University of Manchester researchers has shown.
The researchers suggest that policymakers should increase funding so that deprivation is taken into account as a factor in general practice funding to address income disparities between GPs in more deprived and less deprived areas.
Published in the Journal of the Royal Society of Medicine today (22/04/25) and funded by the National Institute for Health and Care Research, the researchers analysed data from over 8,500 GPs between 2015 and 2021 in the GP work life survey
They looked at the relationship between deprivation of practice population and job pressures, job satisfaction, reported income, working hours, and intentions to leave direct patient care.
The lead researcher is Dr Michael Anderson, an NIHR Clinical Lecturer at The University of Manchester and practicing GP.
He said: "This study shows how the socioeconomic deprivation of practice populations in England is adversely linked to the working conditions of the GPs that work there.
"We highlight a clear and persistent challenge in ensuring equitable healthcare provision.
"Without targeted investment and policy interventions, the difficulties faced by GPs in deprived areas will only continue to worsen, exacerbating health inequalities."
Key Findings also included:
- GPs in the most deprived areas earn less than those in wealthier areas with an average difference of £5,525 less per year.
- Despite higher job pressures, there were no differences in overall job satisfaction, hours worked per week, or intentions to leave patient care between GPs working in more deprived and less deprived areas.
Professor Matt Sutton from The University of Manchester, senior author of the study, added: "Though deprived populations have higher needs for GP services, we know these areas have the most difficulty recruiting and retaining GPs.
"Our study is the first to examine how working in deprived areas affects the working lives of GPs. Addressing their concerns about increased job pressure and decreased resources would help reduce health inequalities."
According to the researchers, the findings explain why working in areas of greater deprivation is less attractive to GPs, exacerbating workforce recruitment and retention issues.
Dr Anderson added: "Alongside financial incentives, non-financial incentives such as enhanced career development opportunities including fellowships that incorporate time for additional training, research, and leadership responsibilities could be a useful lever to promote GP recruitment and retention in areas of greater deprivation".
"We also think it's important to acknowledge we find no differences in hours worked per week, job satisfaction, and intention to quit direct patient care in more deprived and less deprived areas.
"Despite the challenges experienced by GPs working in areas of greater deprivation, this suggests that there are many rewarding aspects of working in areas of greater deprivation. A broader recognition by the GP community of the potential advantages of working in areas of greater deprivation would therefore be helpful to promote recruitment and retention."
This article reports the findings from independent research commissioned by the Department of Health and Social Care and carried out by the Policy Research Unit in Health and Social Care Systems and Commissioning (PRUComm). The research was conducted by the Health Organisation, Policy, and Economics (HOPE) group within the Centre for Primary Care & Health Services Research at The University of Manchester. The study was funded by the National Institute for Health and Care Research (NIHR) Policy Research Programme. The views expressed are those of the authors and not necessarily those of the Policy Research Programme, NIHR, or the Department of Health and Social Care
- Deprivation and General Practitioners' working lives: Repeated cross-sectional study is published in the Journal of the Royal Society of Medicine, DOI: JRSM-24-0273.R2 and is available here.
