The increasing demand for primary care consultations is being absorbed by nurses and other practice staff, rather than GPs, according to latest data analysis.
Trends identified by the Nuffield Trust think-tank show that the rise in the number of consultations being carried out by practice nurses is far outstripping a similar rise for GPs.
Natasha Curry, a senior fellow in health policy at the trust, highlighted that headlines about a “crisis” in general practice had become commonplace over the last year or so, with medical bodies describing a chronic shortage of GPs.
To investigate, the Nuffield Trust analysed a subset of GP practice data taken from 337 practices in England between 2010-11 and 2013-14.
She noted that the data revealed that patient pressure on primary care services as a whole had certainly increased.
“Consultations with GPs rose by approximately 2%, whereas consultations with nurses rose by 8%”
Among the practices analysed, the total number of consultations rose by around 11% over the three-year period looked at. The number of consultations per person per year registered on a practice list also rose – from 7.6 to 8.3
This was supported by previous estimates that suggested the number of consultations in general practice had risen by 13% between 2008 and 2013.
But Ms Curry said that, while activity in general practice had increased, most of that increase was among staff groups “other than GPs”.
“Consultations with GPs rose by approximately 2%, whereas consultations with nurses rose by 8% and consultations with ‘other’ staff – a long list of professionals including pharmacists, physiotherapists, and speech therapists – grew by 18%,” she said.
The think-tank said that, although it was “cautious” about extrapolating national trends, its dataset was the most extensive used as a basis for published research on the issue of GP demand since 2009.
Ms Curry added: “Our analysis provides some insight into what has happened to consultation trends since the last formal publication of estimates in 2009, showing that the largest increases appear to be for nurses and staff other than GPs.
“That raises questions about the assumption that a rapidly rising number of consultations is driving pressure on GPs,” she said.
Ms Curry noted that, while it was clear GPs believed they were experiencing “rising and unsustainable” workloads, it was not clear “exactly where that pressure is coming from”.
The findings were revealed in a recent blog by Ms Curry on the Nuffield Trust website.