Practices in England delivered around 784,000 more appointments in a 10-week period at the start of 2021 and over 5.5m more items of clinical admin work – such as referrals, prescriptions and messages to patients – compared with the same period last year, analysis of RCGP surveillance data reveals.
The figures confirm that overall day-to-day GP workload has increased sharply even before the pressures of an unprecedented vaccination campaign that has seen more than 33.7m COVID-19 jabs administered – mostly in general practice – since mid-December.
Analysis of data for weeks 2-11 of 2020 – the first 10 complete weeks last year – and the same 10 weeks in 2021 shows that face-to-face GP consultations and GP home visits halved as practices followed advice from NHS England to adopt a total triage model and shift to predominantly remote consultations.
However, telephone consultations – considered by some to be more work intensive and stressful because doctors unable to see patients in person carry more risk – and e-consultations more than doubled over the period, meaning that total consultations over the 10-week period were up more than 2% compared with last year.
Clinical admin work delivered alongside this rise in consultations, meanwhile, has exploded – rising by 34% in 2021 compared with last year.
The figures do not include the work practices have carried out in delivering millions of COVID-19 vaccinations every week since mid-December.
NHS England said last week that GP practices were currently delivering around 1m more appointments per week than before the pandemic – but the GPonline analysis suggests this is likely a significant underestimate. The figures cited by NHS England are likely to be low because data on GP appointments collected by NHS Digital do not fully reflect telephone consultations – by far the leading means of delivering appointments during the pandemic.
GPs under pressure
RCGP chair Professor Martin Marshall said: ‘This analysis demonstrates just how hard GPs and our teams have been working over the last few months – and it doesn’t include the full extent of the key roles we’ve had in delivering either the COVID-19 vaccination programme, or the expanded flu vaccination programme.
‘As well as continuing to deliver the care and services our patients rely on us for, alongside the vaccination programmes, this data from the college’s Research and Surveillance Centre shows a marked increase in clinical admin workload. This includes making prescriptions, writing referral letters and communicating with patients via text – all vital for patient care, particularly while a significant proportion of patient contacts are being delivered remotely.
‘It is abundantly clear that general practice is operating under intense workload and workforce pressures. GPs and our teams are have delivered around 75% of COVID-19 vaccinations in England, while striving to continue business as usual as much as possible.
‘We are at and will continue to be at the forefront of caring for those whose health has been directly or indirectly impacted by COVID-19. We urgently need more GPs and more members of the practice team to continue delivering the care our patients need, now and in the future.’