England’s ‘deadly’ GP crisis deepens: Staff numbers fall to lowest level on record

The number of qualified GPs has dropped to its lowest level on record and just one in four family doctors work full time, according to official data that highlights the ‘catastrophic’ crisis in general practice.

There were around 27,500 fully-qualified, permanent family doctors working for NHS England last month, down from about 28,000 in June 2021 and 1,500 fewer than five years ago.

The figure comes despite Boris Johnson’s 2019 manifesto pledge to increase GP numbers by 6,000 by 2024. Ministers have since admitted that target will not be met.

Health bosses have warned the crippling workforce shortages, combined with unprecedented demand for a GP following the pandemic, has created an untenable situation that threatens patient safety. 

Meanwhile, just 23 per cent of permanent NHS GPs work 37.5 hours or more a week, a drop from one third in five years. It follows research showing most family doctors now only work three days or less a week.

Patients have struggled to secure appointments or see a doctor face-to-face, which has seen some desperate people resort to turning up at A&E.

Separate figures suggest other NHS staff are increasingly picking up the burden as GPs wrestle staffing problems.

Data for June shows fewer than half of all appointments were carried out by qualified doctors. The rest were seen by other staff, including nurses, physiotherapists and even acupuncturists. 

Nearly one in five appointments nationally lasted five or fewer minutes last month, in what campaign groups said was a sign GP surgeries have turned into ‘revolving door’ practices in an effort to get patients in and out as fast possible to get through huge workloads. 

Appointments are meant to last no less than 10 minutes according to NHS best practice, while unions have pushed to increase the time to 15 minutes to ensure ‘quality of care’.

Meanwhile, around 65 per cent of appointments were made face-to-face during the month, down from nearly 80 per cent before the pandemic.

Increasing numbers of doctors are reducing their working hours and retiring early, while some are leaving to the private sector or abroad because of the huge increases in pressure put on them. 

The NHS Digital data shows the number of full-time equivalent GPs that are fully qualified have dropped to its lowest level since records began in September 2015. 

All figures are based on the number of full-time equivalent posts in the GP workforce, and do not include trainees or locums. 

Emily Jones, director of risk and healthcare at consultancy firm Broadstone, said: ‘The declining number of qualified GPs in the UK is pushing the NHS to breaking point as demand continues to rise amid a growing backlog. 

‘The crisis risks a vicious spiral as more GPs quit the practice due to the intensifying workload heaping further pressure on those that remain in service.

‘Patients are now waiting longer than ever for appointments with their GP for new diagnoses as well as ongoing treatments for existing conditions like cancer and diabetes. 

‘This is having a catastrophic impact as life threatening illnesses are being left undiagnosed until it is sadly too late for effective treatment.’

Meanwhile, the proportion of GPs working part-time between – 15 and 37.5 hours a week – has climbed from around six in 10 (62 per cent) to seven in 10 (69 per cent), according to figures for June.

GPs said doctors have been forced to drop their working time to avoid burnout because of the ‘unsustainable’ pressures being put on them by ever-increasing demand.

Professor Martin Marshall, chair of the Royal College of GP, told MailOnline: ‘Despite repeated promises to boost GP numbers, today’s figures show that we have more than 1,500 fewer qualified, full-time equivalent GPs than we did five years ago. 

‘The result is a chronically over-stretched and under-resourced general practice service, with GPs and their teams working to their absolute limits to deliver increasingly complex care to the ever-rising number of patients that need it.

‘This is reflected in today’s GP consultation figures, which show general practice is continuing to deliver more consultations every month than pre-pandemic, with more than 26million appointments delivered in June, and over 44 per cent of those on the same day they were booked.’

He added: ‘Working at this intensity is unsustainable and it’s unsafe for both patients and staff. An exhausted GP is not able to practice safely or deliver the high-quality care and services they are trained and want to deliver for patients. 

‘This is leading to GPs and other members of our teams burning out and having to evaluate their futures working in general practice, in some cases leaving the profession earlier than planned and in others reducing contracted working hours to make the job more sustainable. 

‘Yet working “part time” in general practice often means working what would normally be considered full-time, or longer — and will likely include many hours of paperwork on top of patient appointments.’

Separate data from NHS Digital shows the proportion of appointments where patients are seen by qualified doctors fell to just 49.9 per cent last month, down from 50.2 per cent in May.

The figures are calculated based on the number of sessions with a GP in attendance as a proportion of all appointments, which include some appointments where the type of healthcare professional was not recorded.  

This means there may have been slightly more appointments that were attended by GPs than are reflected in the data. 

One in six appointments in the country lasted up to just five minutes last month, with even higher proportions seen in some areas of the country.  

NHS Suffolk and North East Essex Integrated Care Board saw 20 per cent of patients in five minutes or less.

The area with the next highest proportion of sub five-minute consultations was NHS Nottingham and Nottinghamshire Integrated Care Board (19.9 per cent)

It was followed by NHS Leicester, Leicestershire and Rutland Integrated Care Board (19.6 per cent), NHS Lincolnshire Integrated Care Board (19.4 per cent) and NHS Gloucestershire Integrated Care Board (19.1 per cent).

Dennis Reed, director of elderly charity Silver Voices, told MailOnline: ‘I find it difficult to comprehend how a GP visit can take less than five minutes. That hardly provides enough time to take your coat off and sit down. 

‘Routine and speedy transactions, such as repeat prescriptions or blood pressure checks are now carried out by other practice staff, and it is only complex cases, which are referred for GP attention. 

‘These “revolving door” statistics show the pressures that GPs are under and the potential dangers to patient safety from rushed diagnoses.’

The British Medical Association (BMA) — a trade union representing nearly 160,000 doctors — advises all appointments last at least 15 minutes to ensure ‘the quality of care provided, preserve patient satisfaction, and reduce the need for repeated consultation with patients’.

Appointments are supposed to be fixed at 10 minutes according to NHS best practice. More than half (51.8 per cent) of appointments lasted less than 15 minutes, according to the figures.

Meanwhile, the proportion of GP appointments that were face-to-face rose slightly to 64.8 per cent last month, up from 64.1 per cent in May. 

The amount of consultations that are made in-person are still below pre-pandemic levels, with concerns raised doctors are less able to spot potentially dangerous diseases over the phone or on Zoom calls. 

The data comes after the annual GP Patient Survey earlier this month revealed half of sick patients have not seen their GP in the last year, with most saying it was because they could not get an appointment. 

Of patients who had avoided seeing a GP in the past year, more than a quarter (27 per cent) said they found it too difficult to book an appointment — more than double the number in 2021 (11 per cent).

Some 20 per cent were worried about the burden on the NHS, while 12 per cent said it was due to being worried about catching Covid, down from 17 per cent in 2021.

Of those who did manage to see a doctor in the last 12 months, half (49 per cent) said they were not seen as quickly as they wanted, up from 41 per cent.

Just 56 per cent said they had a good experience making an appointment compared to 71 per cent a year ago.