GP workload has grown "hugely" with a 13 per cent increase in face-to-face consultations and a 63 per cent increase in telephone contacts – an increase of 15 per cent overall – according to a report "Understanding pressures in general practice" from The King's Fund.

As well as population increases, changes in other services such as community nursing, mental health and care homes, communication issues with secondary care staff, changes in medical technology and new ways of treating patients, have all played a role in the rise.

The increase in workload for general practice has not been matched by a transfer in the proportion of funding or staff, suggests The King's Fund. The number of GPs has grown more quickly than the population, but has not kept pace with groups most likely to use primary care (over 65s and over 85s) and GPs are increasingly opting for ‘portfolio careers’ or part-time work.

New models of general practice should include new types of delivery, "striking a balance between working at scale and making services responsive to local people", recommended the report.

Improvements to the existing system should prioritise: "structured support for general practice, redesign of commissioning systems to reduce bureaucratic burdens, repairing relationships between primary and secondary care, more use of technology, and better utilisation of community assets to meet patients’ needs".

Policies to change and extend access should also be accompanied by commensurate increases in funding and support, said the organisation.

An independent review of community pharmacy services is due to be conducted by The King's Fund this year.