England is facing a growing problem in its healthcare system due to a shortage of doctors. According to a BBC analysis, general practitioners (GPs) in the country now have to manage 17% more patients compared to nine years ago. On average, each permanent GP is responsible for more than 2,300 patients, an increase of almost 350 since 2015. This rise has contributed to worsening access to general practice services, with patient satisfaction steadily declining.
The analysis also highlighted that certain areas are under even more pressure. In these regions, GP list sizes exceed 3,000 patients, nearly double that of areas with better doctor-to-patient ratios. Experts have raised concerns about this disparity, warning that it poses a significant risk to patient health. The government, meanwhile, has stated that it is developing plans to address the issue by training more doctors and easing the burden on GPs by shifting some responsibilities to pharmacists.
The study focused on permanent GPs, excluding locums and trainees. Among the areas most affected by the shortage are Thurrock, Leicester, and Blackburn with Darwen, where each GP has over 3,000 patients. In contrast, areas like Wirral and Stockport, with fewer than 1,850 patients per GP, are in a much better position. This uneven distribution of doctors is expected to be a major talking point at the Royal College of GPs’ annual conference, where the decline in access to GPs in poorer areas will be highlighted. Professor Kamila Hawthorne, chair of the RCGP, is expected to address how the increasing number of patients per GP is having a severe impact on the health of local populations.
Although some differences in GP numbers can be explained by varying levels of illness in different regions, Dr Becks Fisher of the Nuffield Trust has called the variations “significant and unwarranted.” She emphasised that while many people struggle to secure appointments, the challenges are not distributed equally across the population. Fisher suggested that funding should be better allocated to support areas experiencing the most severe shortages. Louise Ansari, chief executive of Healthwatch England, further noted that access to GP appointments is the top concern raised by patients, with vulnerable groups such as unpaid carers, disabled individuals, and people on lower incomes facing the greatest difficulties.
Patient satisfaction with GP services has reached an all-time low, with one in six patients now waiting more than two weeks for an appointment. Despite GPs receiving less than 10% of the overall NHS budget, they are expected to manage an ever-increasing workload. Earlier in the summer, the British Medical Association (BMA) launched a “work-to-rule” campaign, including measures like capping patient appointments, in response to what they see as a funding crisis. Dr Katie Bramall-Stainer, a BMA GP leader, described the situation as one where GP practices are expected to “do more for less,” and warned that general practice is at risk of collapse.
NHS England acknowledged the difficulties many people face in getting appointments and admitted that surgeries in some parts of the country are struggling to recruit the staff they need. Although there has been a slight drop in the number of patients per GP compared to last year, the situation remains dire. Since 2015, the number of permanent GPs has fallen by more than 1,000, with just 27,193 full-time equivalents remaining, despite the growing and ageing population. While there has been an increase in the number of GPs in training, Labour has promised to go further, not only by boosting GP training but also by giving pharmacists more responsibility for treating minor ailments such as sore throats and shingles.
To help alleviate the pressure, GPs have received additional funding to hire extra staff, including nurses and physiotherapists. A spokesperson for the Department of Health and Social Care also noted that the government has worked to reduce red tape, making it easier to recruit new doctors. The government remains committed to working with the NHS to ensure that everyone can access GP services more easily, with reforms aimed at improving access and easing the strain on general practices.
The ongoing shortage of GPs in England continues to strain the healthcare system, with more patients relying on fewer doctors. While efforts are being made to address the crisis, the impact on patient care is already visible, and it remains to be seen whether upcoming reforms will sufficiently relieve the pressure on general practices.
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