10% fewer GPs, record high appointments: how remote consultations are transforming healthcare

The pandemic has powered new ways of working across the NHS, and remote care has seen an unprecedented rise in both primary and secondary care. It allowed care to continue in the midst of a pandemic, and now, in the aftermath that has left the system heavily stretched, it provides a way to reach more patients despite a depleted workforce.

The data shows that the ratio of face-to-face appointments per GP across England has not changed. GPs are providing just as much face-to-face activity per person as they were pre-pandemic, though at first glance this may be easily missed.

Compared to the beginning of 2018, there are now 2,500 fewer fully qualified GP FTEs. With the current yearly ratio of appointments:GP, we would have expected them to carry out approximately 15m appointments. Despite this significant workforce loss, primary care is delivering more appointments than ever, and the number of monthly appointments per GP has increased by 30% since 2018 (first year for publicly available data on appointments in primary care).

GPs have undoubtedly been working harder, as they tell us, and one of the benefits of remote care shows in the chart below. GPs are now performing roughly the same number of face-to-face appointments per GP that they were at the end of 2018 (this is strictly GP-led appointments, rather than across primary care). Additional capacity is coming from the rise in telephone and video appointments and triage.

Moreover, despite the negative press that often surrounds primary care, the average wait per appointment to see a GP has decreased by 25% compared to 2018. Again, given the fall in the GP numbers, a more positive narrative is that this is a tremendous achievement despite having lost 10% of their workforce in four years. The majority of patients are also satisfied with the service provided, given that only 10% of patients would rather see a GP face-to-face.

How long primary care will be able to plug the holes and work harder is a key question. We have applied public health drivers to forecast demand in primary care, and it paints a dire picture: by 2032, we’d need 39,000 GPs to match demand. There is no quick fix, and a strategy is needed on several fronts, including addressing public health drivers, training and retention. In this scenario, we should expect and welcome the emergence of new ways of working, as innovation may help GPs find time for more patients when there are only 24 hours in a day.