Nine million patients would need to move GPs if surgeries adhered to ‘safe limits’, startling analysis shows.
Under widely accepted guidelines, practices should have no more than 1,800 patients on their lists for every full-time equivalent GP employed.
Yet MailOnline’s investigation exposing the abysmal state of general practice today reveals 3,000 breach this threshold.
That is close to half of all GP surgeries open in England, with the offenders catering for almost 30.6million patients between them. Getting them within the safe threshold would mean either purging them of 9.4million patients or hiring another 5,200 family doctors.
Experts say the system is like an ‘elastic band stretched to breaking point’, with MPs branding it a ‘national scandal’.
Ministers are under renewed pressure to fix the crisis in general practice and banish the hated 8am scramble for appointments millions face every morning.
MailOnline readers can see how dire the situation is in their area by using our search tool.
Simply type in your postcode or town to see how practices within a 5-mile radius of your home fare, in regards to how many patients are competing for GP time and how many doctors actually work there. You can also your surgery’s actual name to see its results, if it happens to be located further afield.
The figures – for March this year, the latest NHS data available – are listed in terms of the number of full-time-equivalent (FTE) GPs.
FTE is considered a more accurate measure compared to a simple headcount, given how swathes of doctors only work part-time.
Monks Park Surgery in Bristol had the lowest ratio of doctors to patients in the data – one per 47,249.
This was followed by The Bowling Green Street Surgery in Leicester (1:44,325) and Jai Medical Centre in Edgware (1:38,050).
Yet neither had the equivalent of one full-time GP.
For GP practices meeting that criteria, Wembley’s GP Pathfinder Clinics recorded the highest ratio of 1:18,151 patients. It runs five sites across north west London but all of its books are linked to the one site at Hazeldene Medical Centre.
The Modality Enki Medical Practice in Birmingham ranked second under that method (1:14,014).
Such figures are far above the widely accepted ‘safe’ ratio of 1,800, peddled by trade magazines, industry leaders and local NHS committees.
The British Medical Association (BMA) warns even that threshold is too high.
GPs tasked with bigger lists might feel rushed or overworked, which experts warn can increase the risk of missing early signs of serious illness in patients.
MailOnline’s audit found 48.9 per cent of the 6,219 practices with available data were above the safe threshold.
Sixty surgeries exceeded the 10,000 ratio, including 14 with at least 20,000 patients for the equivalent of one full-time GP.
NHS Digitial’s statistics are self-reported by practices and, therefore, may have been logged incorrectly.
Some practices’s may have list-sizes inflated by so-called ‘ghost patients’. These are patients who may have died or relocated but are still registered.
The analysis doesn’t include nurses or other patient-facing roles who might carry out appointments.
The GP crisis has been bubbling away for years, despite multiple ministerial promises to fix it.
In total, there are now 28,281 fullly-qualified full-time GPs in England. Numbers have dwindled over the past decade despite attempts to recruit thousands more.
Many are retiring in their 50s, moving abroad or leaving to work in the private sector because of soaring demand, paperwork and aggressive media coverage in the NHS.
Studies suggest most GPs, who pocket up to £110,000/year on average, now only work three days per week.
At the same time, the population has also grown, exacerbating the problem.
It means millions of patients are rushed through, in scenes compared as ‘goods on a factory conveyor belt’.
Some have described it as being impossible to see a GP, with a Glastonbury-esque to get an appointment.
Patient satisfaction has, as a result of the never-ending appointments crisis, plunged to its lowest level in four decades.
Health Secretary Wes Streeting earlier this year announced a £900million package which the Government claimed would ‘bring back the family doctor’ and finally end the scramble for appointments.
As part of the agreement, from this October surgeries will be required to let patients request appointments online during working hours.
GPs will also be freed from ‘pointless box-ticking’ exercises to give them more time.
This represented the first time in four years the Government and GP representatives have agreed reforms to GP contracts.
Edward Argar MP, shadow health and social care secretary, said: ‘GPs are the backbone of the NHS in our local communities, working incredibly hard to deliver for their patients, but they remain under real pressure, added to by the cost of Labour’s NICs Jobs Tax.
‘Under the last Conservative government, 50 million more GP appointments a year were delivered compared to 2019, and thousands more GPs were recruited in England to help make it easier for patients to see their doctor.
‘The Labour Government must ensure their GP contract announcement earlier this year isn’t just a headline, but genuinely delivers real change in reality for GPs to allow them do what they do best – treat patients.’
Jess Brown-Fuller MP, Liberal Democrat primary care and hospitals spokesperson, said: ‘Millions are being forced to endure a standard of care that is simply unacceptable and potentially unsafe.
‘We have heard countless stories of people waiting anxiously, in pain and unable to get the care they need. It is a national scandal.
‘The Conservative party’s shameful record brought us to this point but the Labour government has done next to nothing to turn this awful situation around.
‘Ministers can no longer sit idly by and just accept this situation as the new normal. GPs are leaving in their droves and with an ageing population we cannot allow this to deteriorate further.’
Dr Katie Bramall, chair of the BMA’s general practice committee in England, said: ‘GPs and anyone who has tried contacting their own practice already appreciate that we have a huge shortage of GPs in this country.
‘We are stretching the ability and capacity of our family doctors to breaking point.
‘We urgently need a national GP retention strategy and funding to recruit GPs who are actively completing their training programmes and looking for work.
‘We would even argue 1,800 patients per GP is too many and needs to be reconsidered in light of the number of patients with complex and multiple illnesses rising, which has a knock-on impact on the amount of work needed to deliver safe patient care.
‘We need Government support and funding into general practice, so we can bring back the family doctor, and give patients the best care possible.’
Professor Kamila Hawthorne, chair of the Royal College of GPs, said: ‘As of last month, every full-time GP is on average responsible for a huge 2,254 patients, 111 more than five years ago.
‘This is really concerning as the workloads we are facing aren’t sustainable for GPs and aren’t safe for patients.
‘Our own polling found over three quarters of GPs think that patient safety is being compromised by their excessive workloads.
‘GPs and our teams are now delivering more appointments than ever before – nearly two million more a month than last year – but with just over 150 more qualified GPs than in 2019.
‘We’re working incredibly hard to deliver more and more but we don’t have the GP numbers to keep up – and it’s our patients who are bearing the brunt when they can’t get the care they need when they need it.’
She added: ‘General practice is struggling, but with the right investment and initiatives to recruit and retain GPs – and break down barriers to qualified GPs securing employment – we can turn this around.
‘We just need to be given the right tools to enable GPs to get back to delivering the care that we want to deliver and that our patients need.’
What the GP practices said
Saurabh Johri, of Bowling Green Street Surgery in Leicester, said: ‘The national figures only take into account salaried GPs. Bowling Green Street Surgery has several regular GPs who have worked at the surgery for a number of years and are not salaried, therefore will not appear in the figures. In addition, care delivery at GP Practices has changed significantly with a wide mix of specialist health professionals available to patients. Depending on their condition, our patients will see one of our Advanced Practitioners, Pharmacists, a First Contact Physio or Nurse to ensure GP appointments are there for those who specifically need a GP. This allows us to continue to meet increasing demand and ensure patients receive the right care for their needs.’
