A “sudden decline” in GPs combined with ever-growing demand has led to “the hardest time in general practice”, a leading Suffolk doctor has said.
Dr John Havard, of Saxmundham Health, said practices such as his have "never been so busy" because greater numbers want to see GPs - at the very time there are fewer and fewer of them.
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NHS figures published for the most recent clinical commissioning group (CCG) board meetings showed a "sudden decline" in Suffolk and north Essex GPs in the first quarter of the current financial year.
While there was a slight recovery between June and September, the area was left with 446 full-time equivalent GPs excluding trainees in September 2019, compared to 478 a year earlier.
Amanda Lyes, director of corporate services and system infrastructure for NHS Ipswich and East Suffolk, NHS West Suffolk and NHS North East Essex CCGs, said: "Although we've seen a fall in the number of GPs, there has been a sizeable increase in the number of other health professionals employed by GP practices who are providing direct patient care, such as physician associates and physiotherapists."
However Dr Havard said a team of four "care navigators" at Saxmundham Health are bombarded with up to 500 calls a day, equivalent to one every 1.3mins - with many people wanting to see a GP.
He said there was a "domino effect" where: "If practices lose a partner, there's more work that comes to the others and suddenly the whole thing becomes unsustainable."
Yet he believes the biggest reason for the rise in workload - above even an ageing population - is that "patients consult their doctor three times more often".
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He added: "That's the big behavioural change.
"All the other ones are factors, but the massive one is that everyone sees their doctor more often.
"You used to be able to see people really quickly but now the pressure on appointments is so intense.
"It's never been so busy. This is the hardest time in general practice - and I've been here 34 years.
"It's just become a day-to-day slog. It's a real worry."
As a result, Dr Havard believes that: "We've got to use a GP's skills more carefully, because there are fewer of them.
"That's why we have nurses, paramedics, physiotherapists and others working with us. That's the way we can make it work."
Ms Lyes said the "shift in primary care from being wholly GP focussed to new multi-disciplinary teams of health professionals reflects the changing needs of patients, especially the increasing demand from an ageing population with long-term needs, and also the well-known issues around NHS recruitment".
She added: "A GP appointment is not now needed for many health conditions, and by having a team of healthcare professionals on hand, with a wide range of experience and specialisms, it means people can receive the most appropriate care and enable GPs to treat those with more serious conditions."
However she also said the CCGs are working with NHS England, as well as schools and colleges, to improve GP recruitment.
David Pannell, chief executive of Suffolk GP Federation, said: "The reduction in Suffolk's GP numbers has been expected because a significant portion are now entering retirement age.
"This trend is likely to continue for several years.
"However, it is noticeable that this year many more GPs have trained locally and are staying in Suffolk to work. This is really positive.
"Practices have adapted to the reduction in GPs by introducing new roles. Many now have a mix of pharmacists, advanced nurse practitioners, paramedics, prescribing nurses, physiotherapists and physician associates.
"This has contributed to our practices offering a record number of patient appointments each year.
"We have lots of initiatives to support GPs to stay working. For example, last year we ran a 'Bring a Baby' session for parent GPs which combined play and essential medical training.
"We also have a programme to support any GP wishing to move to Suffolk."
Dr Dan Poulter, who combines his role as a mental health doctor with his duties as Central Suffolk and North Ipswich MP, said: "GPs are seeing more and more patients every day, but every patient requires paperwork and form filling.
"Some of it is good practice but some of it is where the healthcare system makes life hard for healthcare officials.
"The amount of paperwork required for each patient can be extensive."
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