Admin staff now outnumber GPs at over 90 per cent of surgeries, MailOnline can reveal amid the never-ending appointments crisis.
Some practices have 22 backroom staff such as receptionists for every one family doctor.
Patients’ rights campaigners today demanded NHS officials investigate the ‘unjustifiable’ variation uncovered by our analysis.
Critics claimed that practices ‘have gone overboard on hiring idle workers’, saying ‘pen pushers are sitting pretty while phone calls remain unanswered’.
Unrelenting demand for GP consultations has been compared to the rush for Glastonbury tickets, with millions of patients competing for limited slots every morning.
This map shows the GP practices with the highest number for full-time-equivalent receptionists per family doctor
Insiders estimate general practice as a whole is short of around 7,000 family doctors, who earn six figure salaries, on average. Doctor numbers have dwindled over the past decade while patient lists have soared, piling pressure on surgeries already struggling to cope.
MailOnline’s analysis involved figures submitted by practices themselves to the NHS in April – the latest available. Full results are available in a searchable table.
Matrix Medical Practice in Chatham, Kent, had 22.5 full-time-equivalent (FTE) admin staff on its books, compared to its single FTE GP.
The majority of admin staff are receptionists, yet the term also includes estate workers and managers.
Similarly high rates were logged at Kirby Road Surgery in Dunstable, Bedfordshire, (14.7 FTE admin staff per GP), JS Medical Practice in Tottenham London (14) and East Lynne Medical Centre in Clacton-on-Sea, Essex (13.9).
At the opposite end of the scale, Borough Green Medical Practice in Sevenoaks recorded having 11.3 FTE GPs and only a single FTE admin staff, giving the lowest ratio of admin staff to family doctors in England.
But practices like these were in the minority. Of the 5,967 practices in the NHS data with at least one FTE GP, only 7.5 per cent had a one-to-one ratio of family doctors to admin staff or lower.
Dennis Reed, of Silver Voices, a campaign group for senior Britons which has advocated for better access to GPs, said: ‘You can’t really justify one full-time-equivalent GP to 22 backroom admin staff.
‘[It] definitely needs to be investigated as to why there is this absolutely huge gap between different practices and the number of back-up staff compared to doctors.’
He added that the data suggests some practices are focusing on managing patients through telephone systems rather than treating them, with these staff acting as gatekeeper to access to consultations.
‘When there is such a crying shortage of GPs and pressure on patients to be able to get an early GP appointment I would of thought the priority in all practices is to increase the number of GPs rather than the number of backroom staff,’ Mr Reed said.
‘Some practices may have lost their sense of priorities. There seems to be too much emphasis on the bureaucracy of it all rather than the actual frontline service.’
Mr Reed said patients might feel like they have no choice but to describe intimate health matters to receptionists in order to justify getting a GP appointment.
‘It particularly puts older people off who are not keen to describe, possibly intimate symptoms over the phone or, even worse, at a reception desk in front of other people,’ he said.
William Yarwood, from the TaxPayers’ Alliance, said: ‘Taxpayers will be shocked when they realise how many pen pushers are sitting pretty while phone calls remain unanswered.
‘While efficient record keeping is crucial, some practices have gone overboard on hiring idle workers with little to show for it. GP surgeries must focus precious resources on tackling long waiting lists and urgent demands instead of back office bureaucrats.’
There are now just under 41,000 FTE receptionists employed across all GPs services in England, overall NHS figures show. When modern NHS records began in 2015, the toll stood at around 33,000.
GPs, who now usually work around three days a week and pocket six-figure salaries on average, have failed keep pace.
NHS data show there are about 36,500 FTE regular family doctors employed at practices in England. However, this figure excludes locum staff who plug temporary gaps in staffing rotas.
An NHS spokesperson said: ‘The NHS remains one of the most efficient health services in the world when it comes to admin, with administrative costs of less than 2p in every pound of NHS funding, compared to 5p in Germany and 6p in France – providing taxpayers with excellent value for money.
‘GP practices are now delivering record numbers of appointments for patients, and in April they delivered 6million more appointments than before the pandemic.
‘Admin staff play an essential part in delivering this and maintaining day-to-day operations.’
While more appointments may have been delivered compared to pre-pandemic, fewer are actually being held in person.
NHS data for April shows only 64.5 per cent of GP practice appointments were held face-to-face – compared to about 80 per cent before Covid hit.
Doctors’ unions have defended the role of receptionists amid the appointments crisis, describing them as trained ‘care navigators’ that direct patients to the most appropriate service, cutting down on the workload of GPs and saving them time
Professor Kamila Hawthorne, chair of the Royal College of GPs, said: ‘We absolutely understand patients’ frustration when they are struggling to see or speak to their GP.
‘General practice is under enormous pressure, and we know patients’ experiences are being affected.’
‘The reality is that we simply don’t have enough GPs for the number of patients who need our care.
‘The average number of patients per fully qualified GP is now 2,294, meaning each GP is, on average, responsible for 154 more patients than there were five years ago.
‘Practices are coming up with solutions to triage as best they can and improve patient access, but ultimately, if we are going to be able to provide patients with the timely appointments they deserve, we need more GPs.’
Professor Hawthorne called for the public to tell all parties campaigning to lead the country to commit to efforts to increase the number of family doctors.
MailOnline’s analysis compared FTE rates in the primary care workforce. This is considered a more accurate measure compared with a simple headcount, given that swathes of GPs only work part-time.
The NHS classifies much of its GP data as ‘experimental’, a designation meaning it is still undergoing evaluation for quality.
As GP practices record the data themselves before passing it over to the NHS, this means there is a potential for errors to occur which can influence the results.
The struggle to access GP appointments is a complex problem, with doctors themselves reporting being overwhelmed by patient demand.
Under guidelines GPs are told not to deliver more than 25 appointments a day to ensure ‘safe care’. But some doctors are reportedly having to cram in nearly 60 in every workday.
The result is millions of patients being rushed through appointments, which critics have described as being treated like ‘goods on a factory conveyor belt’.
Struggling to access timely GP appointments also has knock-on effects to other aspects of NHS care like A&E, with patients unable to get their health issues seen at the primary level seeking help from emergency departments.
Many of the GPs currently working in the system are now retiring in their 50s, moving abroad or leaving to work in the private sector because of soaring demand and NHS paperwork.
This exodus risks exacerbating the workload crisis, as the remaining family doctors have to take on more and more appointments, increasing the risk burnout.
MailOnline approached all 10 named GP practices for comment.
Harefield Practice practice manager Scott Ridley echoed many of the points made by Professor Hawthorne, and that recruitment of family doctors was a key problem.
‘There are simply insufficient trained GPs to meet the needs and demands of the current UK population,’ he said.
‘The media backlash against GPs after the pandemic has resulted in people leaving, much faster than they can be trained unfortunately.’
He added that while the practice has recently added two new GPs, which would not yet be reflected in the NHS data, the practice was also being hit by problems caused by wider-NHS bureaucracy and time pressures.
‘For the hospital teams, the only way they seem to be able to create any headspace, is to hand over work that used to be done in hospital to the GP Practices — chasing up results of investigations they have arranged for example, or asking the GP to follow up a patient and re refer if necessary — rather than following up the patient themselves,’ he said.
‘There is a sense that all paths lead to General Practice, no problem is too complex and no issue is too small for patients to be advised to contact their GP.’
Mr Ridley said another factor limiting Harefield’s ability to employ more GPs was it currently had nowhere for them to work.
‘The top half of our NHS owned building has been empty and unused for several years because the NHS can’t afford to pay itself for us to access the space and use it for our patients,’ he said.
East Lynne Medical Centre’s associate practice operations manager Allison Forecast told MailOnline comparing admin staff to GPs oversimplifies their work and can be ‘misleading’.
She highlighted that the centre is a ‘a nurse and allied health professional-led practice’ and that they have two FTE GPs employed, not the 1.3 as recorded in the NHS data.
Ms Forecast added that a good admin team enabled clinical staff to work with patients rather than deal with paperwork, improving patient care.
‘Each member of our team has specific, vital roles that ensure we deliver an effective and efficient multi-disciplinary primary healthcare service,’ she said.
‘In conclusion, a simple ratio comparing GPs to admin staff does not accurately reflect the comprehensive and multidisciplinary approach we take to patient care.’
Source: Mail Online
