Visiting a GP could become a thing of the past for most patients as staffing levels reach a “tipping point”, analysis has shown.
In the “near future,” patients will be more likely to date other office members, such as a controversial nurse or medical associates, a study has found.
Doctor visits have fallen by a fifth over the past decade, while the number of patients has increased by 40 percent.
But while the overall medical staff has increased with demand, the number of GPs per 1,000 patients fell by 15 per cent.
Experts have warned that the trend will effectively end continuity of care, with elderly patients often forced to see less qualified staff such as controversial doctoral associates or nurses.
Doctor visits have fallen by a fifth in the past decade, while the number of patients has increased by 40 percent. Archive image
Researchers from University College London (UCL) and the London School of Hygiene and Tropical Medicine (LSHTM) analysed NHS data alongside figures from other sources, including the regulator, the Care Quality Commission.
The number of people registered with an NHS GP practice in England rose by 11 per cent from 56,042,361 to 62,418,295 between 2013 and 2023.
Meanwhile, the total number of GP practices fell from 8,044 to 6,419 over the same period, a drop of 20 percent.
The GP workforce has increased by 20 per cent, but the number of doctors has not increased in line with population growth and many now choose to work part-time.
Overall, the number of full-time GPs fell from 27,948 to 27,321, according to results published in the BMJ.
This means that there are now 0.45 general practitioners per 1,000 patients, compared to 0.53 a decade ago.
The researchers found that GPs still provide half of all consultations, while nurses account for about 20 percent.
Other patient care workers, such as pharmacists, physician assistants and social workers, carried out another 20 percent, while it was unclear who carried out the remaining 10 percent.
The authors wrote: ‘The decline in the number of GPs offering the same number of consultations (per 1,000 patients) appears unsustainable; therefore, it is likely that there will be a tipping point in the near future where the majority of consultations in English general practice will no longer be staffed by GPs.
‘Maintaining relational continuity of care will be more difficult to achieve if there is a shortage of GP consultations and if patients need to see different doctors for different problems, this will likely have implications for quality of care.’
Roles such as pharmacists, social prescribers and physician associates increased by 67 percent between 2015 and 2022 as part of an effort to fill gaps in service provision.
Administrative posts increased by 14 per cent over this period and account for more than half of the NHS GP workforce by September 2022.
Large practices, with lists of more than 20,000 patients, have also increased from 81 to 355, or from one to six percent.
The study did not include all GP surgery work, such as handling correspondence, prescriptions and checking test results, while the workforce data is unlikely to cover overtime, which is common in general practice.
GP leaders said they provided an average of 30 million appointments a month last year, more than 4 million more each month than in 2019.
This is despite the number of fully qualified, full-time equivalent GPs falling by 601.
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Professor Kamila Hawthorne, president of the Royal College of Family Physicians, said the findings made it “very clear” that more GPs were needed.
She said: ‘We need to recruit more people, but fundamentally we need to retain more people in the profession for longer, providing patient care.
‘While GP workloads are increasing, both in volume and complexity, they are falling on fewer GPs than they were five years ago.’
The British Medical Association has raised concerns about the role of GPs and has drawn up its own guidelines stating that they should not diagnose patients.
A Department of Health and Social Care spokesman has promised to “fix” what he called “broken” primary care by shifting the focus of healthcare from hospital to the community.
He said: “We have also committed to recruiting an additional 1,000 GPs into the NHS by the end of this year, announced a pay rise for GPs and practice staff and will ensure practices have the resources they need to offer patients the highest quality care and meet increasing patient demand.”
