Four charts that highlight rising GP workload

Rising pressure on general practice over the past decade has brought the profession to a point where the vast majority now support a cap on workload. GPonline looks at the level of workload GPs face, and the factors behind it.

More than four out of five GPs now support a cap on the number of face-to-face consultations they should be able to provide per day - with most backing a cap of 30 per day or less - according to a recent GPonline poll.

Many GPs currently deliver in excess of this figure, however, and many of the 600-plus GPs who responded to our poll warned that heavy workload was putting patients at risk. Some said they were retiring early, or reducing the hours they worked to avoid burnout.

Despite health secretary Jeremy Hunt's pledge to increase the GP workforce by 5,000 by 2020/21, GP numbers remain in decline. Numbers of patients, meanwhile - and crucially, numbers of patients in the older age groups likely to visit GPs most, many with multiple long-term conditions - have risen sharply.

GP numbers have fallen since 2015 while patient numbers grew

The sharp decline in GPs opting for partnership roles (see graphic above) in recent years will dial up the pressure on the rest of the workforce, because evidence from GPonline's polling shows that this group are something of a workload sink for the profession - tending to work longer hours and complete more consultations per session than either salaried or locum GPs.

More than a third of full-time partners work more than 50 hours a week, compared with just 12.8% of full-time sessional GPs.

Comparing the number of consultations per average session that GPs deliver shows that partners and salaried GPs are more likely to report that they regularly provide 20-30, 30-40 or more than 40 per session.

But across all GPs, many are at times forced to take on huge numbers of patient consultations per day in the current environment - with more than a quarter saying they had carried out more than 50 consultations in a day at some point in the past year.

GP leaders have warned that an injection of funding well beyond the GP Forward View pledge of an extra £2.4bn a year by 2020/21 will be needed to pull the profession out of the current crisis, and the charts above lend weight to this claim.

One GP responding to our poll said: 'It feels important to have a discussion about the reality of workload limits and the real dangers of the inabilty to think clearly that result from too many consultations. The additional workload of results/emails and paperwork add to this.'

Another said: 'It is getting harder and harder to get through the work and feel you are delivering a safe/satisfying service to patients.'

The BMA has warned that under current plans general practice will remain underfunded by £3.4bn by the end of the decade.

The union is expected to publish guidance on managing workload imminently - and GPs will have to hope that this will keep them going until a political consensus for a step change in GP funding can be achieved.

Read more
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Can we set workload limits in general practice?
>
Four in five GPs back cap on face-to-face consultations
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Dr Chris Mimnagh: There is no one-size-fits-all for GP workload limits
>
Can NHS England's 10 High Impact Actions help GPs manage workload?

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