Board papers published by NHS England on 25 March highlight the major shift in how GP services have been delivered since the pandemic began last year - and the increase in pressure on practices.
They also make clear that demands on general practice are likely to remain high as the health service plans for a COVID-19 booster campaign alongside seasonal flu jabs.
By late January this year, general practice was delivering around 15% more consultations than in the equivalent week last year once COVID-19 vaccination work is factored in, according to NHS England.
Vaccinations per day increased by 7% in February compared with the final two weeks of January - suggesting that total consultations rose still further in that month. They figures could also be a significant underestimate, because NHS Digital acknowledges its data on appointments do not fully capture telephone appointments in general practice.
GP workload
The NHS England board papers say: 'General practice care has been transformed, adopting a total triage model, streaming COVID-19 and non COVID-19 patients and delivering an enhanced service for care homes - the oximetry at home service - and maintaining the shielded patient list.'
The papers add that '99% of practices now have video consultation capability, and over 95% have online consultation capability' - and that rates of requests from patients sent to practices via online consultation systems this January were more than double the levels seen at the start of the pandemic.
Requests via online consultation systems 'more than doubled from around 250,000 per week to over 550,000 per week between March 2020 and January 2021', the NHS England papers reveal. Data from the RCGP show that around one in three GP consultations are currently face-to-face - with the majority of patient contacts excluding those for vaccinations taking place remotely.
Pressure on the profession is likely to remain extremely high throughout the year - with the backlog of care in other parts of the NHS having a knock-on impact on demand in primary care, and with the NHS currently planning a COVID-19 'revaccination campaign' in autumn or winter this year.
COVID-19 booster
NHS leaders are 'planning on the basis that we will need to run COVID-19 and seasonal flu vaccination campaigns in parallel', the board papers confirm.
They add: 'As set out in the government’s roadmap published on 22 February, it is not currently known for how long people who receive a COVID-19 vaccine will be protected. This is because, as is the case with many vaccines, the protection they confer may weaken over time.
'It is also possible that new variants of the virus may emerge against which current vaccines are less effective. As well as working closely with manufacturers, scientists are assessing the impact of some variants of concern on the vaccines currently in deployment.'
NHS England acknowledged 'pressures on general practice' from the vaccination programme and the second wave of the pandemic - and highlighted measures set out in January allowing practices to limit non-essential work.
The board papers also acknowledged the impact of a major expansion of the shielding list in mid-February.