The GPs we're losing didn't leave medicine. They left the admin.

Walking into Best Practice London this year, the first stall was a Canadian GP recruiter.

Not a clinical system. Not a recruitment platform for UK practices. A pitch to leave the UK, promising visa support and a better work/life balance at more than double the pay. That's where we are. The most visible message at the UK's biggest primary care conference is: there's a way out, and it's somewhere else.

The NHS has a retention problem

Since 2015, the number of FTE GP partners has declined by 29%. These doctors aren't leaving medicine; they're leaving the pressures we put on primary care here in the UK. They're reducing sessions, moving to portfolio working, to sessional roles, to anywhere the boundaries are clear and the inbox is someone else's problem.

Who can blame them?

Most GPs trained for complex diagnostics, long-term relationships with patients, managing multiple conditions over decades, prevention, early intervention. Instead, they spend their days on inbox management: 100+ items a session, abnormal blood results without systematic process, chasing documentation, fighting an appointment book that doesn't match demand. None of that is what they signed up for. None of it is what their patients need them doing.

The average full-time GP is now accountable for the care of 2,203 patients; this is 265 more than in September 2015. As the number of FTE GPs goes down, the demand placed upon them has steadily increased. As the government moves to put more focus on neighbourhood and community settings, we can expect that demand to continue to increase.

Take the admin away

The honest read on this is that what we're asking primary care to do is something the conditions don't allow. The demands keep growing, and the tools that are meant to lighten the load fail to do the thing they promised to do. The people best positioned to lead the prevention shift the NHS keeps talking about are the same people most at risk of walking out.

The bit of this we can actually move is the clinical admin. Not because it's the whole story, but because it's the part that doesn't need to sit on a GP's desk at all. Results management, documents processing, the triage admin layer - this is work that needs to be done by GPs, but absorbs hours of clinical time and produces no clinical value being done by a partner. It is, quite literally, the easiest hour a day to give back.

The question is whether we keep treating that hour as each practice's individual problem to solve (another rota, another protocol, another evening) or whether we treat it as what it is, which is a structural failure of how primary care work is allocated.

Because the GPs who've left or reduced hours aren't telling us they stopped caring. Quite the opposite: they're coming to ask to continue working in the system they learnt in and love. They're telling us the job stopped being the job. If we want them back, we have to make the work worth doing again. That starts with giving them back the part of it they trained for.