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‘Vicious cycle’ of workload pressures facing GPs in deprived areas

by Anviksha Patel
9 May 2019

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Growing pressures in the health sector are disproportionately affecting GPs in deprived areas, according to new analysis.
The report published by the Health Foundation yesterday found that GPs in deprived areas have more patients and increased workload from higher patient numbers.
The new analysis showed the number of patients per GP is 15% higher in the most deprived 10% of CCGs than the least deprived 10%.
This means that a GP working in a deprived area can on average be responsible for 370 more patients than a GP working in a non-deprived area, which the authors say is ‘not true for every CCG, but the general trend is nonetheless worrying.’
Health inequality is also exacerbated in poorer areas with people experiencing multiple health conditions at an earlier age, according to the research.
Figures show in the least deprived fifth of England, people are expected to have over two conditions by 71 years old.
In the poorest areas, however, ‘people reach the same level of illness a decade earlier.’
The report also analysed NHS Digital data from April, which showed a 4% decrease in the number of full-time equivalent permanent GPs between September 2015 and September 2018.
That equates to a reduction of 1,180 permanent GPs in just three years.
According to Government data from last year, in the most deprived areas, GP workforce fell 50% faster than the wealthiest regions over the last 10 years.
Ben Gershlick, senior economist at The Health Foundation, said: ‘The vicious cycle of falling GP numbers driving increased workload is clear. Combine this with population growth and the picture is even more worrying.
‘Our analysis shows that pressures on GPs are more pronounced in deprived areas, where health need is greatest and which are already losing GPs at a faster rate.’
He added: ‘To make good on the commitment in the NHS Long Term Plan to reducing health inequalities a set of coherent actions are needed focused on encouraging recruitment to areas of high deprivation. Without this, there’s a risk of further perpetuating this cycle.’
New research from the Nuffield Trust also confirms areas such as North West London and the East of England having the lowest number of GPs per 100,000 people.
RCGP chair Professor Helen Stokes-Lampard said: ‘Demand for GP services is escalating both in terms of volume and complexity – and when this is compounded by falling GP numbers, it creates a perfect storm that is leading to GPs becoming stressed and burning out, and in many cases leaving NHS general practice far earlier than they might otherwise have done.
‘We need see more measures implemented to genuinely tackle soaring workload as a matter of urgency and efforts redoubled to cut red tape that diverts time away from patients, and we need to make the working environment in general practice supportive and sustainable, so that family doctors aren’t forced out of the profession.’
She added: ‘This would not just be in the best interests of GPs, but the NHS as a whole, and most importantly, our patients.’
Previous research from the Nuffield Trust has found that patients in poorer areas find it harder to get a GP appointment and confirmed the number of patients per GP was higher.
A workload survey by our sister publication Pulse, where this article was first published, revealed that over half of GPs say they are working beyond safe levels. 
This story was first published by our sister publication Pulse.