GPs demand greater focus on underdoctored areas as access inequalities grow

GP leaders have called for a greater focus on recruitment to underdoctored areas as new statistics revealed a growing disparity in access to care between England's least and most deprived areas.

Consultation (Photo: SolStock/Getty Images)
Consultation (Photo: SolStock/Getty Images)

Research by QualityWatch, a joint Nuffield Trust and Health Foundation programme, found that 64.4% of people living in the most deprived areas of the country had a ‘very good’ or ‘fairly good’ experience when making a GP appointment in 2017/18 - compared with 72% of people in the least deprived areas.

This 7.6-percentage point difference is nearly double the gap just six years earlier - because the proportion of patients reporting a good experience overall in the most deprived areas has fallen 12.5 percentage points since 2011/12, while in the least deprived areas it has fallen by just 8.8 percentage points.

GP leaders labelled the growing disparity in access to care 'worrying' and have called for greater efforts to attract GPs to work in under-doctored areas.

The statistics add to a growing body of evidence which suggests that people in poorer parts of the country are finding it increasingly difficult to see their doctor. Last summer, a survey revealed that three out of five people in England’s most deprived areas found it difficult to book a GP appointment.

GP access

The report suggested that shortages of GPs and nurses combined with a greater increase in the number of patients with multiple health problems in deprived areas was making it more difficult for people to access GP services.

It added people who lived in the most deprived areas ‘had worse access to, experiences of, and outcomes in their care’.

Researchers also found that waiting times in A&E departments had worsened across the country, but over the last three years, this had happened more quickly in the most deprived areas.

Responding to the findings, BMA GP committee chair Dr Richard Vautrey, said: 'People living in deprived areas are already more likely to suffer from poor health and be living with multiple long-term conditions, so it is particularly worrying that there is also a growing disparity in access to care.

'There have been incentives to get more GPs to work in under-doctored areas, but we need to see these schemes rolled out more extensively to ensure all patients get the care they need and deserve, regardless of where they live.

'Above all we need to invest much more in general practice across the board, so that doctors can provide the best possible care to all their patients.

RCGP chair Professor Martin Marshall said: ‘Where a patient lives and their socio-economic status should not have an impact on their ability to access healthcare, yet we know that it does and this must be addressed. We have a severe shortage of GPs and other members of the practice team right across the country, but this is particularly pronounced in areas of high deprivation.

GP workforce

‘The government has pledged significant investment in primary and community services and 6,000 more GPs – we need to see comprehensive plans laid out as to how they will deliver this, particularly how they plan to retain existing GPs in the profession, and how they will target under-doctored areas.’

Government figures published in 2018 showed that the full-time equivalent (FTE) GP workforce was falling 50% faster in the most deprived areas in England over the past decade, decreasing by 16.6% in the decade from 2008 to 2017, compared to 11% in the less deprived areas.

Ahead of the December 2019 general election, the Conservatives promised to improve GP access by recruiting 6,000 more GPs and 6,000 other staff in primary care to deliver an extra 50m appointments.

These additional staff are on top of the extra 20,000 primary care staff expected to be employed through primary care networks (PCNs).

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