GP visits could soon disappear for good as a 40% increase in patient numbers puts doctors at a ‘tipping point’, analysis shows
Analyses show that for most patients, a visit to the GP could become a thing of the past as staffing levels reach a ‘tipping point’.
A study has shown that in the ‘near future’ patients will more often have an appointment with other practice staff, such as a nurse or controversial junior doctors.
The number of doctor visits has fallen by a fifth over the past decade, while the number of patients has increased by 40 percent.
But while the number of practice staff has increased due to demand, the number of GPs per 1,000 patients has fallen by 15 percent.
Experts warn that this trend will effectively end continuity of care, as older patients are often forced to consult less qualified staff, such as controversial doctors or nurses.
The number of doctor visits has fallen by a fifth over the past decade, while the number of patients has increased by 40 percent.
Researchers from University College London (UCL) and the London School of Hygiene and Tropical Medicine (LSHTM) analysed NHS data alongside figures from other sources, including the regulator, the Care Quality Commission.
The number of people registered with an NHS GP practice in England grew by 11 per cent, from 56,042,361 to 62,418,295 between 2013 and 2023.
Meanwhile, the total number of GP practices fell from 8,044 to 6,419 in the same period, a decrease of 20 percent.
The number of GP practices grew by 20 percent, but the number of doctors has not increased in line with population growth. Many doctors are now choosing to work part-time.
According to the findings published in the BMJ, the number of full-time GPs fell from 27,948 to 27,321.
This means that there are now 0.45 GPs per 1,000 patients, compared to 0.53 ten years ago.
Research has shown that general practitioners still handle half of all appointments, while nurses account for around 20 percent.
Other health care providers, such as pharmacists, medical specialists and social workers, performed another 20 percent of the treatments. However, it is unclear who performed the remaining 10 percent.
The authors wrote: ‘It appears that the decline in the number of GPs making the same number of appointments (per 1,000 patients) is not sustainable. Therefore, there is likely to be a tipping point in the near future where the majority of appointments in English general practice are no longer made by GPs.
‘It is more difficult to maintain relational continuity of care when there is a shortage of GP appointments and when patients have to see different doctors for different problems. This is likely to have consequences for the quality of care.’
The number of roles, such as pharmacists, social prescribers and physician assistants, increased by 67 percent between 2015 and 2022 as part of a drive to close gaps in healthcare provision.
The number of administrative jobs has increased by 14 per cent over this period, and by September 2022 this will account for more than half of the NHS GP practice workforce.
Even in large practices with more than 20,000 patients, the percentage has risen from 81 to 355, or from one to six percent.
The study did not capture all the activities of a GP practice, such as managing correspondence, writing prescriptions and reviewing test results. Furthermore, it is unlikely that the staffing data includes overtime, which is common in GP practices.
According to GPs, they made an average of 30 million appointments per month last year, which is over 4 million more than in 2019.
This is despite the fact that the number of fully qualified, full-time GPs has fallen by 601.
Professor Kamila Hawthorne, chair of the Royal College of GPs, said the findings made it “very clear” that more GPs were needed.
She said: ‘We need to recruit more people, but the most important thing is that we keep more people in the profession for longer so that they can deliver patient care.
‘Although the workload of GPs is increasing, both in size and complexity, the responsibility for care lies with a smaller number of GPs than five years ago.’
The British Medical Association has raised concerns about the role of physician associates and has issued its own guidelines stating that they should not diagnose patients.
A Department of Health and Social Care spokesperson pledged to “fix” the “broken” primary care system by shifting the focus of health care from the hospital to the community.
He said: ‘We have also committed to recruiting an additional 1,000 GPs to the NHS by the end of this year. We have also announced pay rises for GPs and practice staff. In addition, we are ensuring that practices have the resources they need to provide the best possible care to patients and meet increased patient demand.’
