GPs in deprived areas care for almost 2,500 patients per head, which is over 300 more than those in more affluent areas, new analysis has shown.
The research, carried out by the RCGP, revealed that the number of patients per full-time equivalent (FTE) GP working in areas with the highest level of income deprivation has increased by 12% since 2018 and at ‘nearly twice the rate of those in the least deprived areas’.
There were also ‘significant’ regional variations, with London GPs being responsible for 2,562 patients per head compared with 2,023 in the South West.
College chair Professor Kamila Hawthorne will highlight these ‘devastating inequalities’ in her speech at the RCGP conference later today, blaming the trend on ‘decades of underfunding’ in general practice.
The analysis sought to estimate the number of registered patients per FTE GP and compare this by deprivation level by calculating a deprivation score for the neighbourhood where registered patients live.
| Level of income deprivation | Registered patients per fully qualified GP FTE |
| Least levels | 2,129 |
| Lower levels | 2,309 |
| Moderate levels | 2,448 |
| Highest levels | 2,451 |
The number of patients per FTE GP in the most deprived areas rose from 2,190 to 2,451 between 2018 and 2024.
Despite this higher rate of increase, even areas with the lowest levels of deprivation saw a 7% rise in the number of patients per full-time GP, up from 1,990 six years ago.
Alongside this data analysis, the RCGP has also highlighted the risk of GP attrition, with a recent survey revealing that over 40% of GPs are planning to leave general practice within five years.
Almost 20% of GPs said that most days they ‘felt stressed and felt they couldn’t cope’, according to a survey carried out across May and June with almost 2,200 respondents across the UK.
Meanwhile, recent research has suggested that over a third of Welsh GPs expect to leave the profession in the next five years.
Half of those who expect to leave said this is based on ‘needing a better work/life balance’.
RCGP Wales chair Dr Rowena Christmas said that ‘investing in general practice is crucial to tackling the wider challenges in the NHS’.
‘It is clear we are part of the solution because money put into general practice speeds up patient care and reduces pressure on hospital services. It is good for the patient, NHS and taxpayer,’ she added.
In her speech today, Professor Hawthorne will call on the Government to ‘take urgent action’ to tackle health inequalities by carrying out a ‘review of all general practice funding streams so that more spending is channelled to areas of greatest need’.
On the research published today, she will say: ‘When I became a GP, it was normal to have a list size between 1,600-1,800 patients. The role was busy and challenging, but it was manageable. Our latest figures reveal that the average is now 2,300.
‘All GPs work extremely hard, and we would argue that almost all areas are under-doctored, but it can’t be right that a GP in Kingston upon Thames looks after 1,800 patients while a GP in Kingston upon Hull, one of the most deprived places in England, is expected to cover twice that number.’
In July, the BMA’s GP Committee England said practices should have a list size of up to 1,000 patients per GP in order to ‘ensure’ safety, and this ask formed part of its manifesto.
The committee has also argued that a cap on patients per GP should be implemented as part of the next contract.
Pulse exclusively revealed in June that GP practices in the bottom 10% of funding per patient have around 1,200 patients per clinical staff member, compared with around 600 in the top-funded practices.
If you download the workforce statistics (Google ‘gp workforce statistics’), in particular the large spreadsheet that has one row per practice, and then look for the columns showing the numbers of registered patients and the numbers of full-time-equivalent doctors (pick the column which excludes trainees and locums) and divide one by the other and then sort largest to smallest you might get a suprise at how few doctors there are per patient in some practices…
The stats partly depend on how ‘full time’ is reported by each practice. GPs gravitate to the jobs where the intensity, hours, pay, working hours and geography works for them. We should ditch the concept of a ‘session’ and work on overall hours instead, with contracts that reflect this.
It is not difficult to imagine the fall in in care especialy in deprived areas by these statistics. It is not uncommon to see that a practice having 8 GP’s is now reduced to 4 or less,out of which 1 to 2 GP’s who claim to be supervising PA’s ,pharmacists etc which is leading sub standard care.These models have no evidence base and never had even a public consultation. There is argument of for saving money on face value and access . Now access demanded by public to GP access not to Noctors access. . They have huge cost which will come into play by demoralised GP workforce, patient presenting in A&E due to delays in care and on huge medicolegal expenses for NHS in near future.
The profession, being honest with itself, will admit there are some GP principals in deprived areas who intentionally maintain high list sizes >2,500 per GP, low staffing/costs, send too many patients to 111/A+E…and thus maintain very high incomes and future high pensions. Practices such as these get a local reputation and no younger GPs want to join them thus creating a vicious cycle….what do we do with these “rotten apples” sort of GP practices? Remove their contract and stick in a bunch of salaried GPs?