North West London GPs face 2,700 patients each

Patients in North West London are experiencing significant pressure on GP services, with an average of more than 2,700 patients for every full-time equivalent family doctor. This ratio is considerably higher than the national average for England, which stands at 2,220 patients per GP. The British Medical Association has recommended a benchmark of 1,000 patients per GP.

Mohammed Rashad, from the Medicines Management Team, described the GP staffing gap in England as a decade-long structural problem, stating that patients feel its effects daily when trying to book appointments. North West London, alongside the Bedfordshire, Luton and Milton Keynes area, currently reports the highest patient-to-GP ratios among all 42 Integrated Care Boards in England. Nationally, four out of five of these boards would need to at least double their full-time equivalent GP numbers to meet the BMA's recommended levels.

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Rising Patient Numbers, Stagnant GP Growth

Since 2015, the number of patients registered with GP practices across England has grown by approximately 6.3 million, a 12 per cent increase. However, the growth in GP numbers has not kept pace with this rise. Despite these pressures, general practices delivered a record 388 million appointments in the past year, an increase of 8.3 million from the previous year, alongside 83 million online consultation requests.

Role of Clinical Pharmacists

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Mr Rashad highlighted the role of clinical pharmacists as a key part of the solution. He explained that pharmacists can manage medicine reviews, handle long-term condition management, and oversee complex prescribing safely. This allows GPs to concentrate on diagnosing and treating patients who require a doctor's direct expertise. He clarified that this approach is not about replacing GPs but ensuring all practice team members work to their full training capabilities, preventing appointments from being used for tasks that pharmacists are equally or better suited to handle.

The number of clinical pharmacists working within general practice has seen substantial growth under the NHS Long Term Plan. By December 2023, there were 6,874 full-time equivalent pharmacists employed in general practice and primary care networks. This represents a 24.5 per cent increase in just one year. The number of pharmacy technicians also rose by over 40 per cent during the same period.

Mr Rashad advised that bridging the gap between the current patient-to-GP ratio and the BMA's recommended benchmark will require years of workforce planning. However, he noted that expanding pharmacist-led care within practices is one of the few available methods that can immediately begin to reduce waiting times. For patients experiencing difficulties in securing appointments, he suggested inquiring with their practice if a query regarding medication, repeat prescriptions, or long-term condition reviews could be managed by the pharmacist team, as these issues can often be resolved more quickly and with maintained quality of care.

Expanding access to clinical pharmacists could provide GP practices in North West London with improved capacity to manage demand while recruitment efforts for GPs continue over the longer term.