GP shortage in poorer areas ‘could widen health inequalities,’ say researchers

GP checking a patient's blood pressure.
GP checking a patient's blood pressure.

New research from the University of Cambridge found that there are fewer GPs per patient in poorer parts of England compared to wealthier regions.

Published

A shortage of GPs in poorer neighbourhoods could “widen health inequalities”, academics have warned.

New research found that there are fewer GPs per patient in poorer parts of England compared to wealthier regions.

In more deprived neighbourhoods, a lack of family doctors is often compensated by nursing roles, the study found.

The research, published in the British Journal of General Practice, examined the number of GPs in each region, for every 10,000 patients in the community.

The researchers, from the University of Cambridge, found that between September 2015 and December last year there were, on average, 1.4 fewer full time equivalent GPs per 10,000 patients in the most deprived areas compared to the least deprived areas.

They said that the lower GP numbers in deprived areas was compensated, in part, by more nurses.

But people in more deprived neighbourhoods also had fewer patient-facing staff.

A prescription and stethoscope at the Temple Fortune Health Centre GP Practice near Golders Green, London.
A prescription and stethoscope at the Temple Fortune Health Centre GP Practice near Golders Green, London.

Dr John Ford, from the Department of Public Health and Primary Care at the University of Cambridge, the study’s senior author, 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.

“There may be some compensation due to increasing numbers of other health professionals, which may partially alleviate the undersupply of GPs in more socioeconomically disadvantaged areas. But this is not a like-for-like replacement and it is unlikely to be enough.”

Claire Nussbaum, the study’s first author, added: “The Government has made reducing health inequalities a core commitment, but this will be challenging with the increasing shortage of GPs in areas of high socioeconomic disadvantage.

Dr Laurence Buckman writes a prescription in his practice room at the Temple Fortune Health Centre GP Practice near Golders Green, London.
Dr Laurence Buckman writes a prescription in his practice room at the Temple Fortune Health Centre GP Practice near Golders Green, London.

“The primary care staffing inequalities we observed are especially concerning, as they suggest that access to care is becoming increasingly limited where health needs are greatest.

“Addressing barriers to healthcare access is even more urgent in the context of Covid-19, which has widened pre-existing health and social inequities.”

Commenting on the study, Professor Martin Marshall, chairman of the Royal College of GPs, said: “All patients should have access to the best possible GP care, regardless of their circumstances or where they live, but a decade of under-investment in general practice means we simply don’t have enough GPs to meet the needs of a growing and ageing population.

“People living in deprived areas tend to have a greater number of long-term health conditions and more complex health needs, and therefore often require greater access to GP care and services.

“Urgent funding is needed for initiatives to attract GPs to under-doctored areas, as well as recruiting more GPs to the profession overall and preventing the ones we do have from burning out.

“The college has been calling on the Government to urgently deliver on its manifesto pledge of 6,000 additional GPs by 2024.

“GPs are gearing up for an exceptionally busy autumn and winter, delivering the expanded flu vaccination programme as well as the Covid booster campaign, on top of managing the fallout and backlog from the pandemic.

“It is more essential than ever that general practice has the workforce capacity to manage both new and existing pressures, so that GPs can continue to deliver high-quality care to patients, wherever they happen to live.”

Dr Richard Vautrey, chair of the general practitioners committee at the British Medical Association, said: “This research not only highlights the severity of the workforce crisis facing primary care, but also the dire consequences it’s having on deprived communities across the country – each one made up of real people, unable to get the timely care that they need.

“Government cannot afford to ignore this any longer; especially in the context of Covid-19, which has created an unprecedented NHS care backlog.

“Without safe staffing levels to overcome it, there will be further detriment to the wellbeing of both staff and patients long into the future.

“It’s clear that previous attempts to increase staffing levels have been inadequate and have failed to bridge the gap, and Government must start taking this crisis and its repercussions seriously.

“These health inequalities are totally avoidable, but the issues surrounding them must be treated as an absolute priority if we’re to build a more equitable society with better health outcomes for all. We simply do not have anywhere near the number of doctors we need in England.”