GP appointments up 31% compared with pre-pandemic levels

General practice in England delivered 31% more appointments in June this year than in June 2019 once COVID-19 jabs are factored in, according to official data that reveal the extent of pressure on primary care.

GP consultations (Photo: Robert Johns/UNP)
GP consultations (Photo: Robert Johns/UNP)

The data show that even excluding COVID-19 vaccine appointments, total appointments in general practice in June 2021 were just over 13% up on the same month in 2019, before the pandemic.

GP practices in England delivered over 31.1m appointments in total in June 2021 according to the figures from NHS Digital - including 4.2m as part of the COVID-19 vaccination programme.

An estimated 26.9m appointments were delivered not including the COVID-19 vaccination programme - up 13.1% from 23.8m in June 2021. Once COVID-19 jabs are included, the rise compared with June 2019 comes to 31%.

GP crisis

The figures come as the RCGP called on 29 July for an 'emergency rescue package' for general practice - warning that the profession was in crisis - with an inadequate workforce left 'at breaking point' by intense demand from an already growing and ageing population, with added pressure on top from the historic NHS backlog.

The college warned that the reduction in demand for GP services normally seen in summer months had simply not materialised this year - as the figures from NHS Digital appear to confirm.

The college's own data also show consultation rates 11% higher than in June 2019 - alongside a one-third increase in clinical administrative workload including prescriptions, referral letters, messages to patients and other tasks.

Meanwhile, GPonline reported earlier this year that the number of fully-qualified, full-time equivalent GPs per patient in England has dropped by 10% over the past five years as numbers of GPs have dropped despite government promises to increase the workforce, while patients registered with GPs have risen.

GP appointments

The NHS Digital figures suggest that 56.3% of appointments - not including millions for COVID-19 jabs - were delivered face-to-face in June, the highest proportion recorded in its data this year.

GP practices have come under heavy pressure to increase in-person access despite delivering more than half of all appointments face-to-face throughout the pandemic, with one Conservative MP calling for practices to 'embrace risk' after the lifting of restrictions on 19 July, and health and social care secretary Sajid Javid telling parliament he expected 'better' access to face-to-face care after the relaxation of pandemic rules.

Another Conservative MP, Damien Moore asked on 27 July in a written question to the health secretary what steps the DHSC was taking 'to encourage general practices to return to in-person appointments'.

Health minister Jo Churchill replied: 'Face-to-face appointments have been available throughout the COVID-19 pandemic and approximately half of all appointments during the pandemic have been delivered in person. NHS England and NHS Improvement wrote to GP practices on 19 July, setting out the expectation that practices should offer a blend of face-to-face and remote appointments, with remote triage where possible.

GP access

'Practice receptions should be open, so patients without access to phones or online services are not disadvantaged. Practices are expected to review their communications to ensure patients know how to access GP services.'

Despite the high level of workload shown in the NHS Digital data, the figures likely underestimate the true scale of workload. NHS Digital says telephone triage and home visits are not counted properly in its statistics, and that 'list appointments' in which a GP may call multiple patients are often recorded as a single event in practice IT systems.

GPonline reported this week on a report from the GMC that found the pandemic had driven a surge in burnout among trainees and trainers - and practices have reported rising pressure from patients testing positive for COVID-19 despite being fully vaccinated.

Commenting on the latest appointments data, BMA GP committee chair Dr Richard Vautrey said: 'Practices continue to be under immense pressure as they strive to meet the growing health needs of people from within their communities. On top of this GPs and their teams continue to play a leading role in the vaccinations campaign.

'In the context of this growing demand, a large backlog of patients across the NHS who did not receive the care they needed throughout the pandemic, and looking forward to what looks to be an incredibly difficult winter, general practice is in clear need of support.

'The BMA has been clear that government pledges on increasing the GP workforce need to be realised so that we have enough family doctors to meet the needs of their patients, while unnecessary bureaucracy preventing staff focusing on patient care must be eradicated for good.'

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