Average GP caring for 300 more patients compared with 2015, warns BMA

GPs in England are caring for an extra 300 patients each on average compared with six years ago - a 15% increase, according to BMA analysis of the workforce crisis facing the profession.

BMA GP committee executive team member Dr Krishna Kasaraneni (Photo: BMA)

General practice in England has 1,700 fewer fully-qualified, full-time equivalent GPs now than in 2015, according to analysis by the association of the latest workforce data from NHS Digital.

The decline in GP numbers combined with a sharp rise in patients registered with GP practices over the period - from around 57.3m in October 2015 to 61.2m in October this year - means each FTE GP in England is responsible for an extra 300 people on average compared with six years ago.

This rise in patients per GP has come at a time when workload delivered by general practice has spiked to unprecedented levels - contributing to pressures that GP leaders have warned are simply unsustainable.

GP workforce

Commenting on the figures, BMA GP committee executive team member Dr Krishna Kasaraneni said: 'Since 2015, when ministers first began making promises about increasing GP numbers, England has lost the equivalent of more than 1,700 full-time, fully-qualified GPs.

'For those left, the average number of patients each GP is responsible for has increased by around 300 - or 15% - over the same period. Most notably, between September 2020 and the same month this year, more than 900 GP partners have quit or retired.

'While new doctors may be choosing general practice, this is not keeping up with the high numbers of GPs leaving or reducing their hours in the face of unsustainable, unsafe workloads and rising hostility against the profession.'

Health and social care secretary Sajid Javid admitted this week that the government was not on track to meet its manifesto commitment to increase the FTE GP workforce by 6,000 by 2024.

Workload pressure

While the workforce remains in decline, workload is rising fast - GP practices delivered 28.7m appointments in September 2021, 8.5% more than the figure for the same month in 2019, and the highest figure recorded for a single month since October 2019.

Once COVID-19 appointments are factored in, total appointments in general practice are up 10.6% compared with September 2019.

Meanwhile, despite criticism over face-to-face access, practices delivered more than 17.3m in-person appointments - 61% of the total. This came alongside more than 10m telephone appointments - a figure three times the pre-pandemic total.

The rise in appointments has also come alongside a massive increase in clinical administrative workload revealed in data from the RCGP research and surveillance centre. Data collected from practices show that clinical administrative work - including tasks such as referral letters and prescriptions - is up by around a third compared with pre-pandemic levels.

Capacity limit

Figures from BMA Scotland reported today by GPonline, meanwhile, reveal that more than four in five practices say workload now exceeds capacity - with around half of these saying excess workload is 'substantial'.

RCGP chair Professor Martin Marshall said this week: 'As GPs, we want to be able to provide the high-quality care that our patients deserve. But as patient numbers rise, and health conditions become more complex, we are under more pressure than ever and we are significantly understaffed.

We now face what is likely to be an incredibly difficult winter, with the potential for a surge in COVID-19 and a likely sharp increase in other respiratory illnesses and flu - and GP teams will continue to play a leading role in delivering the flu and COVID-19 vaccination programmes.'

Doctors' leaders have also urged the government to reform pension tax rules that 'punish senior doctors for working more' to improve retention.

Dr Kasaraneni said: 'Rather than merely recognising that they are way behind their target, ministers must do something tangible about it and take meaningful steps to retain GPs who have spent the last 20 months going above and beyond in the face of the pandemic. They need to listen to and work with GPs on the ground to reach solutions that support family doctors – without doing so they risk losing far more and the situation for patients getting far, far worse.'

Figures published by NHS Digital this week showed that the fully-qualified FTE GP workforce had stalled over the past year, while partners fell by around 3%. The BMA has produced its own analysis of workforce data in recent months after a change in the way NHS data are presented.

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