The rise in part-time working by GPs has left fewer doctors to see patients, research shows.
A study of national data shows the number of doctors and practices has failed to keep up with a growing population.
While the total number of GPs in England rose by more than 2,000 in seven years, the drop in hours meant that the number of full-time equivalent GPs fell by more than 600.
The researchers also said the rise of other roles in surgeries – such as physician associates – means that the majority of appointments will soon no longer be delivered by GPs.
However, this threshold has already been passed, according to separate more up-to-date data.
This July, 43.6 per cent of practice appointments were carried out by GPs, NHS figures show, down from 50.1 per cent in March 2022.
The new study shows practices increasingly closing and merging so that those which remain take on greater numbers of cases.
Between September 2015 and September 2022, the total number of qualified GPs working in NHS general practice in England rose from 34,474 to 36,492.
But after taking working hours into account, this was equivalent to 27,321 full-time GPs, down from 27,948.
Writing in the BMJ Open journal, the team from University College London (UCL) and the London School of Hygiene and Tropical Medicine (LSHTM) analysed NHS data together with figures from other sources, including the Care Quality Commission, the health service regulator.
The study found the average number of GPs fell from 0.53 to 0.45 for every 1,000 patients, representing a 15 per cent drop, with a steeper drop among male GPs.
The researchers said their study did not include all GP surgery work, such as managing correspondence, prescriptions and reviewing test results.
The data showed the average number of other roles in practices, such as pharmacists, social prescribers and physician associates, rose by 67 per cent.
The researchers said the findings showed the number of general practices was shrinking while patient lists were “ballooning”.
The number of people registered with an NHS GP practice in England grew by 11 per cent from 56,042,361 to 62,418,295 between 2013 and 2023.
At the same time, the total number of GP practices in England fell from 8,044 to 6,419 – a 20 per cent drop.
The data also showed the size of GP lists is rising, with the average practice increasing by 40 per cent from 6,967 to 9,724 patients.
‘General practice is bedrock of the NHS’
A Department of Health and Social Care spokesman said: “The NHS is broken and these findings show how much general practice has been neglected, but this government will fix it by shifting the focus of healthcare out of the hospital and into the community.
“We have also committed to hiring an extra 1,000 GPs into the NHS by the end of this year, have 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 increased patient demand.”
Prof Kamila Hawthorne, the chair of the Royal College of GPs, said: “The findings of this study make it very clear that we need many more GPs – we need to recruit more, but crucially we need to retain more in the profession for longer, delivering patient care.
“Whilst GP workload is escalating, both in volume and complexity, this is falling to a smaller number of GPs than we had five years ago. In the past year, GPs and their teams have delivered an average of 30 million appointments per month – over 4 million more each month than in 2019 – while the number of fully qualified, full-time equivalent GPs has fallen by 601.
“General practice is the bedrock of the NHS, and GPs train for at least 10 years to become experts in delivering whole-person medical care, managing complex health needs in the community, and alleviating pressures across the rest of the health service.
“We work in multi-disciplinary teams, and whilst our excellent nursing staff and other members of the wider team, such as pharmacists and physiotherapists, are highly valued, these roles aren’t substitutes for GPs and mustn’t be used to plug gaps in the workforce.”
A Department of Health and Social Care spokesman said: “The NHS is broken and these findings show how much general practice has been neglected, but this government will fix it by shifting the focus of healthcare out of the hospital and into the community.
“We have also committed to hiring an extra 1,000 GPs into the NHS by the end of this year, having provided a further £311 million towards GP contract funding in 24/25 – an uplift of 7.4 per cent – and will ensure they have the resources they need to offer patients the highest quality care.”
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