GP practices in England delivered 312m appointments in total in 2019 - up 3.8m from the previous year - according to figures from NHS Digital.
The data, which allow for the first time a comparison of two full calendar years, show that in 2019 general practice delivered around 1.22m appointments for every weekday - up from 1.2m the previous year.
This increase means that an extra 20,000 appointments were delivered across England's 6,822 practices every weekday compared with the previous year - roughly equivalent to half the annual output of an average practice. GP leaders said the data reflected practices working under 'intense strain'.
Analysis of the figures by GPonline shows that pressure on general practice rose sharply through the second half of 2019 - with total appointments up 5.2m compared with the same period in 2018. In the first half of 2019, however, demand was slightly lower than the year before, with total appointments between January and June down around 1.4m in 2019 compared with 2018.
Just over half of appointments in general practice were delivered by GPs in each of the two years - with 51.5% in 2018 and 51.8% in 2019.
Rising demand for appointments in general practice has put pressure on access, with the proportion of appointments delivered within a week of booking falling from 69.5% in 2018 to 68.1% in 2019.
The figures are a blow to prime minister Boris Johnson's ambition to 'drastically reduce' waiting times for GP appointments - a promise made in his first speech as prime minister in July last year.
BMA GP committee chair Dr Richard Vautrey said: 'These figures show the intense strain practices up and down the country are under, managing increased demand with a dwindling workforce.
'While the number of appointments delivered in practices has increased by more than 3m in 2019, the latest figures show a drop of more than 300 full-time equivalent GPs in a year.
'So while the largest proportion of appointments are delivered on the day of booking, GPs are spreading themselves more thinly, not only risking their own health and wellbeing, but also meaning there are often long waits for patients to see their doctor.'