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Record GP demand ‘outstrips’ capacity, NHS England admits in stark warning 

Record GP demand ‘outstrips’ capacity, NHS England admits in stark warning 

NHS England’s board has issued a stark warning that demand for GP appointments is at record levels and ‘outstrips’ capacity.

Papers released for a board meeting yesterday also revealed that NHS England will look into running a ‘high-profile communications campaign’ to educate patients on key changes such as the use of additional roles staff.

A document on ‘access to primary care’ said that ‘demand for primary care services has never been greater’ as the NHS emerges from the Covid pandemic.

It added: ‘Capacity in some areas, especially in rural or more deprived locations, is stretched and demand is outstripping supply.’

The document pointed to a 35 million increase in GP appointments in the 12 months ending July 2022 compared with the 12 months ending July 2019 – up from 310 million to 345 million.

Speaking at the board meeting, national director for primary care Dr Amanda Doyle said: ‘We’ve got a mismatch in the demand from patients and the workforce capacity available to meet that.

‘We need to address that workload – the workforce we have are feeling overwhelmed and therefore are less likely to stay and to stay full-time.’

The NHS England board also recognised the need for greater retention of GPs, admitting that while there has been increased recruitment of trainees, the number of fully-qualified full-time-equivalent GPs continues to fall.

Dr Doyle pointed out that even as GPs go through training, ‘at every step along the way there is some attrition’.

And she added: ‘Equally important or more important [than recruitment] is retention, we are losing qualified general practitioners faster than we can replace them.’

Board chair Richard Meddings added that the numbers of fully-qualified GPs is ‘actually flat to down’ and that this is ‘a real challenge’.

Meanwhile, the document added that ‘over the coming months’, NHS England will ‘explore the feasibility of running a high-profile communications campaign to help raise awareness of some of the key changes that have been introduced into primary care during the pandemic’.

It said this could include the use of the wider multidisciplinary team, community pharmacy and digital routes to contact general practice.

It follows study findings that ‘inaccurate and unfair’ negative media coverage of GPs in UK newspapers is ‘contributing to workforce stress and the retention crisis’.

The board papers and meeting also revealed that:

  • NHS England is ‘looking at how we develop integrated neighbourhood teams’, as recommended in the Fuller stocktake and recently backed by the BMA
  • One of NHS England’s key priorities is taking ‘immediate action’ to make it ‘easier for patients to get in touch’ with their GP practice as patients are struggling to access services because they cannot through on the phone
  • It will also look at making it ‘easier for patients to directly book’ appointments via the NHS app and online
  • NHS England is working with the Government to address visa issues for IMG GP trainees
  • It is also working with the Government on pensions flexibility to stop ‘perverse incentives’ for GPs to retire earlier
  • Repurposed PCN incentive scheme funding can be used for ‘additional appointments and capacity to support provision of services based on local need, such as respiratory hubs’

And NHS England reiterated that unfunded pay deals combined with inflation may mean it will have to ‘completely revisit investment’ in primary care, as well as other key services.

It comes as the latest official workforce data shows a 16% rise in the number of patients per full-time equivalent (FTE) GP in the past seven years.

The BMA said the numbers highlight the ‘immense pressure’ that practices are facing with rising demand but fewer GPs.

It follows claims from Dr Coffey that GP numbers have been ‘stable’ since the last election despite data showing numbers continue to fall.

Meanwhile, the RCGP has highlighted failings in current GP retention schemes and called for them to be urgently overhauled.



Please note, only GPs are permitted to add comments to articles

Turn out The Lights 7 October, 2022 10:12 am

The management of primary care provision in the uk is akin to the Putin style of army managment.Now we are chucking conscripts at the dwindling front lines as the elite troops get wiped out while being overwhelmed.It will not end well and this admission is to little and to late.

Michael Crow 7 October, 2022 10:59 am

GPs have been saying this for years but it seems to have fallen on deaf ears. Now there is a real crisis for which there is no immediate solution. Time to stop every branch of medicine who can’t be bothered to do their own job from saying “just go to your GP”. GPs are not everyone’s houseman / dumping ground. For the foreseeable future GPs probably need to concentrate on illness not prevention

Joanna Wallace 7 October, 2022 11:05 am

Any GP in the country surprised by this? I’m more surprised that NHSE have admitted it!!!

Simon Ruffle 7 October, 2022 11:22 am

NHSE are still aiming strategy of making it easier to contact practices. All that means is we run out of appointments more quickly. Open up a lane on the M25 and it gets filled.
The narrative of see your GP needs to end. The mantra should be contact a healthcare provider and our staff need the breathing space to be able to signpost people to the best person not always the GP. Online appointments/direct booking have lots of crap in that you can’t triage until you see them and the DNA attend / answer) rate is higher in pre-booked wasting even more time and recurrent calls to the practice. Do not start me on ‘GP to kindly’ requests!!

Fedup GP 7 October, 2022 11:29 am

After several years ands lots of meetings, thousands of cups of coffees, lots of lunches and mid morning pastries, NHSE have told us what we have been saying to them for years. Now they resume their meetings / lunches / pastry breaks to decide if there is anything they could / should do about it.
Fiddling while Rome burns.

David Church 7 October, 2022 11:58 am

NHSE still don’t have a clue, do they?
We are not ’emerging’ from the Covid pandemic ! Boris Johnson dictated that we would not when he decided that we would welcome the virus to become ‘endemic’ in UK, accepting that we would NEVER emerge from the ‘endemic’ status, and would instead live with it here for ever.
Sadly, we have not learnt to ‘live with it’, but everyone tried to pretend, and behaves as if, it no longer exists – which is quite the opposite of ‘living with it’ successfully, as shown clearly by the repeated waves of massive hospitalisations, premature deaths, disability, long covid and distressed children, as we lurch from one wave-peak to the next, becoming the pariah of the world – who will eventually learn to isolate and quarantine our whole country as we remain endemic when they have recovered and emerged from the pandemic – a little like Gruiniard Island and the Anthrax!

Kevlar Cardie 7 October, 2022 12:26 pm

So someone finally tossed teargas into the Clown Conference.

David Jarvis 7 October, 2022 1:09 pm

In the same week NHSE advise people to speak to GP before starting exercise.

Patrufini Duffy 7 October, 2022 3:06 pm

Wow. You’ve seen the elephant. Forget it, there’s a blue whale in your face now.

Bonglim Bong 7 October, 2022 3:41 pm

Where was this sense of urgency when a decision was made not to use the levers build in to the current GP contract to manage sky high inflation.

The options now are fairly limited:
1 – Funding – £50 per GP surgery appointment with no limits, making sure funding flows when appointments increase. (increased each year in line with inflation!)
2 – Get rid of ALL the crappy red tape, make hospitals do their appropriate share of work and stop using GP as a jumping ground.

One of the problems is central managers cannot help themselves in attaching strings to new streams of funding. More work is definitely not what is needed – think more like a doubling of the capitation fee and removing other work.

Truth Finder 7 October, 2022 3:59 pm

After so many years, tons of useless time wasting meetings planning for the next meeting, they finally get it. Lack of qualified GPs.

Decorum Est 7 October, 2022 4:10 pm

Terminate FATPOA
(and standard GP consultation charge is closer to £100 at present)
(HMG to sort out difficulties of affordability)

Adam Crowther 7 October, 2022 5:31 pm

Erm are the board minutes 5 years late. We probably have to value ourselves and our teams a little more. Every interaction or intervention we have has a cost whether that is issuing a repeat prescription, preventing an expensive hospital admission or dealing with tasks and requests generated by countless external parties.

Carpe Vinum 10 October, 2022 9:00 am

Also in breaking news today, confirmation that bears do indeed defaecate in the woods

John Evans 11 October, 2022 10:51 am

The latest BUPA add “what is health?”.
Essentially everything.

Problem is that we the original NHS was never intended to be anywhere near as comprehensive and funding has never been sufficient to meet expectations.

The media and government / organisations will miseducate and parking GPs and their ineffective leadership will never be able to compete.

New strategy needed. You define a number of options that the resources will adequately resource then they can take it or leave it.

You never will get the resources to meet the artificially increased demand. To keep doing the same thing and expect a different outcome is insanity.

fareed bhatti 19 October, 2022 2:16 pm

I find it astonishing that hospitals can continue to reject referrals unilaterally, cancel lists, provide no follow ups for months and specialists being rude to patients with abandon and have no repercussions for that. Cardiology, Neurology, Dermatology appointments are distant dreams, patients in severe pain awaiting surgery are delayed time and again and GPs are dealing with the same patients getting worse again and again. Yet all the funding is doled towards hospitals that continually run in the red with bonuses given to managers and Trust directors for ‘good performance’. Our secondary care colleagues may have their gripes about us but hospitals are paying way over the odds to locum consultants doing the same clinical work, less teaching and training and less admin. What about service provision! We need specialists to see patients and its not just about surgery. I cannot remember now the last time when the specialists said they would review someone and actually did do that on time in any specialty.
Oh and while this happens lets not forget lots of med student and GP training happens in primary care and we are recruiting GPs from overseas, who are lovely people but have significantly higher training needs to embed them into UK GP and NHSE is absolutely sh!tting on the training schemes by centralising them!