The paper presents key findings in relation to six policy questions:

• How many general practices and general practice staff are there?
• What does retirement and succession planning in general practice look like?
• What is the productivity of general practice?
• What are the characteristics and drivers of public contract uptake?
• Are there capacity constraints within the system, and if so, what are the determinants?
• What are the factors that should be considered in forecasting future GP workforce requirements?

The research finds that in 2022 the workforce of GPs and General Practice Nurses and Midwives (GPNM) provided a reasonable level of coverage nationally in response to demand and there was good uptake of public contracts. GPs carried out 19 million consultations annually, 29 per whole-time-equivalent per day. GP Nurses and Midwives carried out nine million consultations annually – 16 per whole-time-equivalent per day. However, some geographic areas had clear capacity constraints, often in areas of growing or ageing populations.

Identified capacity challenges can be addressed by 2030 through the increase in GP numbers that is already underway via increased training places and the International Medical Graduates Programme. By 2030, almost 4,000 graduates and international recruits are expected to enter the system while just over 1,000 GPS are expected to retire and resign. The number of GPs expected to retire is also in line with normal workforce distributions. This increase in capacity will meet constraints in the system currently and future constraints arising from demographics and changes in working practices.

The paper’s recommendations include expanding and streamlining the role for GPNMs, and the adoption of practice-based public contracts to improve public administration. GPNM already provide almost a third of general practice consultations and appear to be an important source of supply and stability in areas with growing and ageing populations. However, an expansion and standardisation of the GPNM’s role could be beneficial. The Strategic Review will identify measures to improve the current system as part of a primary care-focused health service and in line with the Sláintecare vision on access.

P.35 Table 2 Contract uptake among 'Standard' GPs (June 2022) - 
Opioid substitution: Practices - 1009; % all practices - 70%; Accounts - 1666; % all accounts - 60%; % Accounts & non contractors - 49%

P.37 3.1.7 GPs with HSE contracts – patterns in contract holding. Four out of five GPs who engage with high uptake contracts – GMS capitation, GP Modernisation, Under 6, Maternity and infant and CDM - take up all those contracts. As could be anticipated from the contract uptake figures, non-uptake of the Maternity and Infant and CDM contracts explain most of the variance. 6% of GPs that hold a HSE contract do not take up any of these contracts. Again, GPs working in non-standard services (e.g. addiction treatment, family planning clinics etc) are excluded from this count. However, even examining standard general practice services, engagement with the national cancer screening and the opioid substitution services drive GPs with little other contractual engagements with public service into visibility.