The King’s Fund report, Understanding pressures in general practice, released today found that nurses had an 18% increase in their workload, 17% more face-to-face contact with patients and a 70% hike in phone contact.
Practice nurses reported extra workloads from the roll-out of immunisation programmes, including shingles and influenza, but had no extra time to carry out the work.
It also said community nurses who are rarely based in practice are not usually able to help out with home visits.
However, practice nurses are taking on a role of managing long- term conditions, which helps to spread the load, the report found.
The health think tank is calling for urgent action to reverse the cuts in funding so crisis-hit general practice can recruit and keep the workforce it needs to meet increasing patient demands.
The report said “general practice is in crisis” with bigger and more complex caseloads, difficulties in staff recruitment and retention and funding cuts.
Researchers looked at data from 30 million consultations at 177 practices and spoke to staff including GPs, practice nurses and managers and trainee GPs about the pressures they faced.
The report said despite increases in GPs’ workload there was not enough funding or staff to cope with demands.
Consultations in general practice grew by 15% between 2010 and 2015. Telephone consultations soared by 63% and face-to-face consultations grew by 13% over the five-year period.
However the GP workforce grew by just 4.75% and the number of practice nurses increased by 2.85%.
During the same time the NHS overall budget fell from 8.3% to 7.9%.
Other factors contributing to the crisis included a failure to keep pace with the over 65s and over 85s who are most likely to use primary care, consumer demand for immediate care and changes in community nursing, mental health and more work from care homes.
Researchers also found that GPs are increasingly opting for “portfolio careers” as they are put off by the risk of stress and burnout.
Lead author Beccy Baird (pictured) recommended putting general practice at the heart of the sustainability and transformation plans to ensure its voice is heard.
The report also called for “radical change” with innovative models of general practice such as multispecialty community providers, with practice teams collaborating over patient care.
Health Education England needs to develop a workforce strategy for sustainable careers for the practice team.
It is also essential to have adequate staffing levels.
“Otherwise, it will run the risk of spreading an already stretched workforce across longer working hours, thus increasing the workforce challenges.
“If general practice is to remain at the heart of the NHS, it must have an adequate and stable funding stream for core services,” said Baird.
