GP numbers associated with life expectancy in England, study shows

Patients with access to fully qualified GPs, higher funding of general practices and increased continuity of care, live longer according to new research out today (16 April). 

These are the key findings of a study led by Professor Richard Baker at the University of Leicester which looked at most general practices across England. 

He investigated the life expectancy of general practice populations, both male and female, in the period immediately before the pandemic (2015-19). The study was cross sectional and accounted for characteristics of patient populations including: ethnicity, deprivation, and NHS region. The features of general practice that were investigated included funding per patient, numbers of fully qualified GPs, GPs in training, nurses and advanced nurse practitioners per 1,000 patients, along with continuity and access. 

His findings have now been published in the British Journal of General Practice (BJGP).

General practice provides care to everyone in the population. It is under intense pressure because the population is aging and the need for health care is increasing steeply. The number of fully qualified GPs has been falling and continuity and access have been declining. Consequently, general practice is changing, with new approaches to access being introduced and new groups of staff joining the workforce. 

Professor Baker, of the Department of Population Health Sciences at the University, said: “In recent years, both the number of fully qualified GPs and continuity of care have been declining, and general practices are struggling to meet the demands for care of an aging population. Reversing these declines would not only improve access to care but also might improve life expectancy.

“There are several factors which could explain the slowdown of life expectancy including socio-economic inequalities and a slowing of the mortality improvements in cardiovascular disease management, but the possibility that the pressure on general practice may be contributing should now be considered as well.

“While this study cannot prove causation, the findings are consistent with international evidence about the mechanisms of primary care that affect life expectancy, and should trigger concern about the effect of the current general practice crisis on population health in England.”

The study was also carried out by Dr Steve Levene from the University of Leicester, Professor George Freeman from Imperial College London and Chris Newby from the University of Nottingham. 

Professor Baker said: “The findings of the study are important not only because they highlight the role of general practice in improving population health but also because they indicate which features of general practice should be considered in future policy developments. They suggest that health service policies should give priority to increasing the numbers of fully qualified GPs, increasing general practice funding per patient, and improving continuity and access.”