GP workforce crisis threatens sustainability of primary care in deprived areas

GPs working in deprived areas are responsible for 370 more patients on average than their counterparts in the most affluent parts of England, researchers have found.

GP workload (Photo: sturti/Getty Images)
GP workload (Photo: sturti/Getty Images)

The average number of patients per full-time equivalent (FTE) GP in the 10% most deprived areas in England is 15% higher than the number per GP in the 10% least deprived areas, research by the Health Foundation shows.

The findings have huge implications for the sustainability of GP practices in many parts of England - amid significant evidence that deprivation is a major driver of additional workload for GPs.

The researchers warn that patients in disadvantaged areas 'tend to experience worse health, are at greater risk of having multiple health conditions and more likely to have multiple conditions at a younger age'. Recent research from the think tank found that patients in the least deprived fifth of areas can expect to have two long-term conditions by the age of 71 - while patients in the most deprived fifth hit this level of ill health at age 61.

Consultation rate

The findings echo research from leading primary care academics showing that although the GP consultation rate among patients from the most and least deprived groups is relatively similar at the start and end of life, patients from the most deprived groups consult roughly twice as often between the ages of around 50 and 70.

Meanwhile, GPonline reported just over a year ago on research showing that that deprivation was the single biggest driver of missed GP appointments.

Workforce data suggest that the sustainability of general practice in deprived areas could deepen because GP numbers in these areas are falling faster than across the country as a whole.

Figures published by the government last year showed that GP numbers were falling 50% faster in deprived areas than they were in the most affluent parts of England.

GP:patient ratio

This fall comes against a backdrop of overall rising population. The Health Foundation said that 'there are more and more patients per qualified permanent GP, rising from 2,000 to 2,160' over the past three years.

Health Foundation senior economist Ben Gershlick said: ‘The vicious cycle of falling GP numbers driving increased workload is clear. Combine this with population growth and the picture is even more worrying.

‘Our analysis shows that pressures on GPs are more pronounced in deprived areas, where health need is greatest and which are already losing GPs at a faster rate.

'To make good on the commitment in the NHS long-term plan to reduce health inequalities a set of coherent actions are needed, focused on encouraging recruitment to areas of high deprivation. Without this, there’s a risk of further perpetuating this cycle.’

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