It’s frustrating how often GPs get unfairly blamed for the pressures they face, especially when the real causes are rooted in systemic issues and chronic underfunding. When restaurants don’t have a table available, it’s seen as a sign of their popularity or quality. But when GPs don’t have an appointment slot, many people tend to assume it’s due to laziness or inefficiency, which is just not the case.
Increasing GP workloads
There are many posts on different social media platforms about the ambulances stacking up outside A&E departments, the long waiting times to hand over patients and the increased pressures hospitals are under.
Many of those same posts have comments under them blaming GPs; Never being able to get an appointment; Empty waiting rooms, which are indicative of GPs being out golfing, or swimming, cycling, or surfing; and ‘dragon receptionists’ whose job it is to stop people getting appointments.
The workload on GPs has only been increasing, and much of their work is invisible to the public. The countless phone calls, meetings with specialists, reviewing test results, and dealing with complex patient needs all contribute to the pressures that are rarely visible outside of the practice. It’s also concerning how much the system has shifted since the pandemic, with GPs managing more severe cases due to delays in referrals, while simultaneously trying to keep up with a rising number of routine appointments.
The growing number of GP appointments
In December 2024 alone, GP practices delivered 28.4 million standard appointments according to the BMA. 64% of those appointments were delivered face to face. The number of contacts has been rising steadily in recent years, reflecting the increasing demand for healthcare services. This is partly driven by an aging population, higher rates of chronic conditions, and more people seeking primary care for both routine and urgent health concerns.
Supporting those patients takes ever more time. The Government Guidelines suggest that the target from GP referral to hospital appointment is 18 weeks, however it is widely acknowledged that this target has grown longer and longer, particularly with the backlog of waiting lists from the covid pandemic.
Data analysed by the BMA shows that the referral patterns of GPs have changed drastically since the pandemic began, with referrals being timed carefully to avoid them being rejected for a lack of hospital capacity. When those referrals are rejected, the patient’s need for care does not disappear.
The requirements for multi-disciplinary teams
As a result, patients with severe conditions are having to be managed by GPs for far longer than was previously the case, and often with worsening conditions. Those patients require more appointments, and more time, reducing the capacity available to see other patients. As these are the more complex patients, with a higher risk of hospital admission, it’s hard to imagine the strain GPs are under when people assume they’re just ‘fobbing them off’ with other clinicians, when in reality, it’s a strategic move to help manage the load and make sure patients still receive the care they need. The rise of multi-disciplinary teams—like Advance Nurse Practitioners, Pharmacists, and Paramedics—shows how much more comprehensive and complex care has become in primary care.
GPs are doing more with fewer resources
A report by the RCGP in March 2023 noted that GP Practices offered 4.6 million more appointments over December 22 and January 23, than it had in December 2019 and January 2020, at a time when the full time equivalent of GPs were dropping. There seems to be an expectation from the public for GPs to work ‘full time’ and by that, is meant to be seeing patients the whole time.
The expectation that GPs should spend all their time only seeing patients ignores the hidden workload they must manage, including:
- Issuing prescriptions and conducting medication reviews
- Reviewing letters from consultants
- Evaluating test results and deciding on treatment plans
- Writing referral letters
- Clinical meetings to review patient groups and develop skills
- Supervising and supporting practice staff
This extra workload pressure that has come about for GP practices, and secondary care is not the fault of the frontline staff. The underlying issue is a lack of support and resources to match the increasing demand. While the NHS is trying to adapt, there needs to be more understanding from the public, along with better government support, to help GPs and their teams manage the rising patient needs. It seems like a cultural shift is needed—where the work GPs do behind the scenes is recognized and valued.
GP funding is typically 9-10% of the overall NHS budget. This is approximately £12 billion of over £200 billion spent on the NHS. In 2023-24, GP practices in England managed over 300 million GP contacts. This is approximately 90% of the healthcare contacts for the year. These statistics reflect the increasing pressure GPs are under to manage increasingly complex care, without additional funding for more clinical staff.
How can patients help their GP Practice?
The demand on GP practice staff is high, and there are ways that patients can support their practice, through utilising self-care options online, or via the local Pharmacy First Scheme, as well as using online services for things they normally call their practice for, such as viewing test results or ordering repeat medication, even cancelling appointments. The more patients who can use these tools, the more time is freed up for practice staff to support and engage with patients who need their help.
Working Together to help navigate those pressures
Xytal supports GPs and primary care teams by delivering leadership development, process improvement, and coaching to help manage increasing pressures. We equip healthcare leaders with the skills to navigate complex patient demands, streamline workflows to free up appointment capacity, and integrate multi-disciplinary teams effectively. Our coaching programmes build resilience, while our expertise in cultural change helps practices improve patient engagement and expectation management.
