Up to eight-fold differences in the numbers of patients on GPs’ lists in areas of England, new analysis reveals.

 

The list size of fully trained, full-time equivalent GPs is so variable throughout the country that GPs in one area have an average lists of over 8,000 patients while in another area list sizes average of fewer than 1,000 patients.

 

These are extremes but there are plenty of areas where the list size averages are less than 1,500 per GP and others where the averages are more than 5,000 per GP.  There is no system in place to remedy this unwarranted and undesirable disparity.  The introduction of an amendment to the NHS Bill to create a System for Equitable Distribution of GPs in England (SEDGE) has been proposed.

 

A comprehensive analysis of data supplied by NHS Digital’s Primary Care Workforce Team for 31 July 2026 covering all the 1,230 Primary Care Networks (PCNs)in England shows that the discrepancies are widespread throughout the country.  No pattern is discernible, despite the expectation that there might be.

 

The analysis was carried out by John Gooderham, a retired civil servant, who was twice involved in this field: first between April 1981 and December 1983 and then between May 1995 and November 1999, as Secretary and CEO of the Medical Practices Committee for England and Wales (note 3).

 

Previous analyses by others have been undertaken for regions and for counties, ie for larger populations. This is the first time that data for PCNs where the registered patient population is compared with the number of fully qualified full-time equivalent GPs in them has now been conducted.

 

The 20 areas (PCNs) with the highest average list sizes for fully qualified full- time equivalent GPs, in descending order are:

 

Maidstone – 8,306

Brent West – 6,815

Chemer – 6,236

Willows (Leicester) – 5,943

Ilford – 5,487

Luton – 5,480

Spalding – 5,434

Mendip – 5,253

Hull – 4,821

Barking & Dagenham – 4,808

Copeland – 4,724

Medway Central – 4,651

North & Central Brighton – 4,609

Blackpool North – 4,579

Brunel – 4,570

Wyre – 4,447

Bradford – 4,390

Newham North – 4,389

Medway (part) – 4,369

Blackburn North – 4,338

Newham North – 4,4390

 

The 20 areas with the lowest average list sizes in ascending order are:

 

Rochester – 999

Isles of Scilly & South  Kerrier – 1,116

Culm Valley – 1,215

Clissold Park – 1,225

Avon Valley – 1,268

North Tandridge – 1,272

Western Dales – 1,323

East Hertfordshire – 1,327

Tiverton – 1,335

York West & outer NE – 1,365

Hinckley Central – 1,387

Tadley – 1,389

Norfolk North – 1,404

Devon West – 1,405

Chichester Rural North – 1,407

Medway South – 1,407

Lewisham – 1,432

Beverley – 1,441

Henley – 1,443

Derbyshire North – 1,444

 

These league tables are intended to illustrate the most and least adequately doctored areas in terms of their crude average lists.  Any thorough assessment of adequate numbers must take account of a range of other factors, such as deprivation, rurality, percentage of very old and very young patients etc.  Other special circumstances should be considered in any determination of what number of GPs should be allowed in any area.

 

Lord Hunt of Kings Heath intends to table amendments to the NHS Bill when this reaches Lords Committee stage in mid-October, and said:

“This new evidence demonstrates clearly that there is a need for a System of Equitable Distribution of GPs in England (SEDGE) and I will be tabling amendments to the NHS Bill to achieve this”.

The proposals for SEDGE have been considered by DHSC since May, following several PQs by Lord Hunt, and have been shown to other parties with an interest, such as the BMA and the RCGP.