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GP shortages hit areas of high socioeconomic disadvantage harder than more affluent regions, researchers at the University of Cambridge have found. This is a trend that will only worsen with time and is likely to widen pre-existing health inequalities, they say.
In a study published in the BJGP Open, researchers investigated the relationship between shortages in the healthcare workforce and levels of deprivation. The team found significantly fewer full-time equivalent (FTE) GPs per 10,000 patients in practices within areas of higher levels of deprivation.
This inequality has widened slightly over time, and by December 2020, there were, on average, 1.4 fewer FTE GPs per 10,000 patients in the most deprived areas compared to the least deprived areas. However, the lower GP numbers in deprived areas were compensated, in part, by more nurses.
The statistics taken between September 2015 and December 2020 are from the NHS Digital General Practice Workforce collection. They compared this workforce data against practice population sizes and levels of deprivation across England.
Although the number of consultations in general practice has increased, staff numbers have failed to keep up with this demand. The number of GPs relative to the size of the population has been decreasing since 2009, and as doctors are increasingly working part-time, shortages are predicted to worsen with a projected shortfall of 7,000 GPs by 2024.
People living in deprived regions are more likely to have long-term health problems
Dr John Ford from the Department of Public Health and Primary Care at the University of Cambridge said: “People who live in disadvantaged regions of England are not only more likely to have long-term health problems, but are likely to find it even more difficult to see a GP and experience worse care when they see a GP. This is just one aspect of how disadvantage accumulates for some people leading to poor health and early death.”
The researchers say that policymakers must address the imbalance in the recruitment of staff within primary care. They will need to consider why practices and networks in disadvantaged areas are relatively under-staffed and how this can be reversed. Potential options include: increasing recruitment to medical school from disadvantaged areas, enhancing training offers for these roles, and offering practices and networks in under-staffed areas additional recruitment support.
Dr James Matheson, a GP at Hill Top Surgery in Oldham, said: “People living in socioeconomically disadvantaged areas shoulder a much higher burden of physical and mental health problems but have less access to the GPs who could support them towards better health. For the primary care teams looking after them, this means a greater workload with fewer resources – a burnout risk which can further exacerbate the problem.”