Agreement: I AgreeBody: Dear Editor The recent paper (Pettigrew et al, 2025) on GP working patterns has highlighted the loss of GPs to the NHS workforce and the counterintuitive problem of increased GP unemployment, echoing recent survey work done with BMA members about their experience of GP unemployment (BMA, 2025). In October 2024, government opened access for English PCNs to employ GPs within the first two years post CCT from ARRS funding, however, these are only accessible to recently qualified GPs and are a small proportion of new jobs compared to the number of underemployed GPs. In a growing crisis, the lack of employment for newly qualified GPs is extremely concerning, whilst the situation is even more dire for those who have been qualified for more than 2 years and cannot find GP work. The authors note that the gap between GMC licensed and NHS general practice GPs in 2024 represents an estimate £8.6billion investment lost from NHS general practice. If only a small proportion of this loss is due to GP unemployment, it is it still an unforgivable failure in NHS workforce planning and loss to the UK health economy. However, the personal impact on individual GPs harder to estimate. The BMA’s survey revealed concerning responses suggesting that as well as practical financial impacts, there were considerable psychological impacts to not being able to find work as a GP. There needs to be urgent action from government to release funds to enable full GP employment, and this needs to be combined with a programme to support GPs who have been impacted by unemployment and underemployment. If as a society, government fails to invest in this group of GPs who want to work in the NHS, we not only wasting the training, experience and dedication of generations of doctors, but we are also failing our patients and society at large. The BMA. Tackling GP underemployment and unemployment in the UK https://www.bma.org.uk/our-campaigns/gp-campaigns/uk-wide/tackling-gp-un... Pettigrew L M, Bharmal A V, Akl S, Exley J, Allen L N, Petersen I et al. Trends in the shortfall of English NHS general practice doctors: repeat cross sectional study BMJ 2025; 390 :e083978 doi:10.1136/bmj-2024-083978 No competing Interests: No competing interestsThe following competing Interests: I am an very underemployed GP and am really struggling to find work at the moment; I'm also a member of the BMA sessionals GPC I'm also an older recently-qualified GP, as I've taken and indirect route to qualification.Electronic Publication Date: Tuesday, September 30, 2025 - 12:34AI use: No, I have not used AIHighwire Comment Subject: Trends in the shortfall of English NHS general practice doctors: repeat cross sectional studyWorkflow State: ReleasedFull Title: Re: Trends in the shortfall of English NHS general practice doctors: repeat cross sectional study Highwire Comment Response to: Trends in the shortfall of English NHS general practice doctors: repeat cross sectional studyCheck this box if you would like your letter to appear anonymously:: Last Name: DavisFirst name and middle initial: Lucy-JaneEmail: Lucy-Jane.Davis@nhs.netAddress: Devon. UKOccupation: portfolio GPBMJ: Additional Article Info: Rapid response