Around 27m patients in England will have to wait for a week or more to see their GP in 2014, as a result of a dramatic diversion of doctor posts from general practice to hospitals.
New research published today by the Royal College of General Practitioners reveals that three extra hospital consultant posts are now being created for every one more GP across the country.
At the same time analysis of the latest GP Patient Survey, by the College, indicates that the number of people in England waiting for a week or more to see or speak to their GP (excluding nurse appointments) reached 26.2m in the last year. The College says this is projected to rise to 27m next year.
The College says the only way to shift this trend is to increase the share of the NHS budget going to general practice from 8.39% now to 11% by 2017, starting with an increase of one percentage point of the NHS budget next year.
Eleven years ago, there were 2,500 more full-time equivalent GPs than hospital doctors. However, if current trends continue, there are set to be 22,000 more full-time equivalent hospital consultants than family doctors by 2022.
According to the latest national GP Patient Survey, the proportion of patients in England who are having to wait a week or more for an appointment has risen to 15%, compared to 14% a year ago and 13% 18 months ago. The number of people waiting for a week or more to see or speak a GP or nurse at their practice reached 46.8m in the last year. This is projected to rise to 48.4m next year.
An opinion poll, conducted on behalf of the RCGP recently, showed that 71% of GPs expect waiting times to worsen over the next two years due to the decrease in resources for general practice.
This shift in the number of doctors away from general practitioners and towards hospital consultants has taken place at a time when the population in England has grown by nearly four million, with many more people suffering from serious, long-term conditions – and the average number of consultations requested by each patient increasing.
In 2001, the population of England stood at 49.14m. By 2013 this had risen to 54 million.
This diversion of investment away from the recruitment of family doctors towards hospital consultants comes despite the rhetoric of successive governments around the need to divert patient care away from hospitals and into the community, where care can be provided far more cost effectively.
In 2002, there were 27,200 full-time GPs, compared to 24,800 hospital consultants.
In 2012 (the latest year for which figures are available) there were 31,700 GPs compared to 38,200 hospital doctors – meaning there were 6,500 more hospital doctors than family doctors.
By 2022, the RCGP predicts that, unless current trends change, there will be 37,000 GPs compared to 59,000 hospital doctors – meaning there will be 22,000 more hospital consultants than family doctors.
During the period between 2002-2012, the annual uplift in the number of full-time equivalent family doctors was 1.5%. However, the annual uplift in hospital consultants was 4.4%.
In 2002, GPs accounted for 28% of the full-time equivalent doctor workforce, while consultants made up 25.4% – with rest of the doctor workforce being made up by trainee doctors (known as registrars).
In 2012, GPs accounted for 23.2% of the doctor workforce, while consultants made up 27.9%.
By 2022, it is predicted that GPs will make up 15.5% of the doctor workforce, while consultants will make up 24.7%.
The declining numbers coincide with a dramatic slump in the proportion of the UK NHS budget spent on general practice, which the RCGP recently revealed had dropped to the lowest percentage share on record at 8.39% – despite 90% of NHS patient contacts being carried out in general practice.
RCGP Chair Dr Maureen Baker said:
“It is vital to ensure that patients are able to access their local GP quickly and effectively – just as it is important for hospitals to have adequate numbers of qualified consultants to look after patients who are in need of acute health care.
“We need to ensure that we have enough GPs to provide patients with good access to high-quality health care in local communities across the UK.
“Most people want to be looked after in their local community and they want to be able to see their GP quickly. The dramatic diversion of doctor posts away from general practice into hospitals works against this fundamentally important principle.”
She added: “Ministers say repeatedly that we need to alleviate pressure on hospitals by delivering more care in the community, yet the numbers of posts being created for consultants and GPs is completely at odds with this.
“If waiting times get longer, it will be more difficult for GPs to ensure that problems are caught early, and the pressure on A&E will intensify. This is bad news for patients and bad news for the whole of the NHS.”
Patricia Wilkie, Chair of N.A.P.P, said:
“Patients greatly value being able to consult with and speak to their GP who is local, who knows the patient and their family and whom the patient trusts. Sadly very many patients are increasingly having to wait for one to two weeks and sometimes longer to see their GP.
“N.A.P.P. understands the many pressures on GPs. However, unless there is an increase in the overall numbers of GPs and more financial resources to practices to employ more GPs to provide a safe and timely service, patients will have no alternative but to use A&E to receive the medical attention they need. This is not what patients wish nor the best use of NHS resources.”
RCGP Press office – 020 3188 7574/7575/7576
Out of hours: 0203 188 7659
Notes to editor
The Royal College of General Practitioners is a network of more than 44,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.