A top medic has explained why the county has the worst GP-to-patient ratio in Britain.

New figures show Kent and Medway has just 38 family doctors per 100,000 people compared to a national average of 60.

Dr Julian Spinks says a "vicious cycle" of factors means the Garden of England is particularly hard hit.

These include more opportunities in nearby London and retirees not being replaced quickly enough.

And more patients mean more pressure, resulting in unsustainable working hours.

Across the UK there are currently more than 61.8 million patients accessing surgeries.

But the number of fully-qualified GPs has fallen from 28,700 to 27,700 in the last three years.

In Kent there were nine million appointments last year – up from 7.5 million pre-pandemic.

Dr Spinks, who practises in Medway, outlined the concerns across general practice.

He said: "There is a problem right across the country with the number of GPs falling but it's becoming a particular problem here.

"We have some of the biggest list sizes and that means people have even more difficulty getting to speak with their GP.

"These days a typical practice has around 10,000 patients and the ratio of GPs to patients has worsened.

"It was around 1,800 patients per GP now there are lots of practices where it is well over 2,000, some over 2,500 and in some cases where practices cannot recruit new GPs they are going up well over 3,000."

Looking across all of Kent's data, KentOnline has highlighted the practices with the highest and lowest patient-to-GP ratios.

The Maritime Health Practice on St Mary's Island in Chatham stood out as the worst – with only four GPs for 27,704 patients, its ratio is almost 7,000 to one.

At the other end of the scale, Lamberhurst surgery in Tunbridge Wells, has four doctors for 2,760 patients – making it the only practice with a ratio under 700 to one.

However, some surgeries did not show full data so these numbers are subject to accurate records.

Across all boroughs the worst-affected practices average around 2,000 patients to one.

It could be thought a way to fix this would be to simply recruit more GPs but Dr Spinks points out this is easier said than done.

He added: "The main reason for the lack of doctors is there are a lot of people retiring.

"Also Kent is close to London and so people tend to go there to finish their GP training and stay rather than return here.

"Kent is a lovely place to live and so it's sad we have difficulty with getting GPs to come here.

"We need to start to tackle the big waiting lists because that is also one of the reasons they don’t come.

"If they work here they face having to look after more patients than other parts of the country and it's a bit of a vicious circle.

"The more people leave or practices don't recruit, the more difficult that situation becomes."

And with fewer GPs it means the same workload rests on fewer, more tired shoulders.

Dr Spinks continued: "A typical GP day, your work in a practice starts before 8am and goes on to at least 6.30pm – generally without a break.

"Then some days when you are doing extended hours you work until 8pm – I even have colleagues who are working two to three hours at home to complete paperwork.

"It’s something you can maintain for sometime but ultimately you start to burnout.

"GPs are desperate to provide as good a care as we can but we don’t have the numbers and we do not have the premises and the funding to meet the demand the public deserves.

"The amount of time available to support patients has gone down and doctors want to provide good quality care.

"This needs time for us to be able to do that with all our patients and you can’t do that if you’re rushing through to see 40 to 60 patients a day."

It is an issue in serious need of addressing and one which Dr Spinks believes starts with recruitment.

"We have to make general practice more attractive and most particularly here in Kent and Medway," he added.

"One of the things we are going to have is the new Kent and Medway Medical School meaning we’ll have a new generation of doctors coming out of there who have spent time in Kent and may be keener to stay."

Dr Spinks also thinks a different means of considering GPs would help reduce the workload.

He said: "I think we need to start looking at general practice much in the same way you would look at a general hospital.

"You wouldn’t expect the doctor to be doing everything, you would have nurses providing nursing care, physios doing that sort of thing the pharmacist would come round and make sure your medication is safe.

"In general practice, we’re moving towards that."

The views of Dr Jeremy Carter, who practises at Park Surgery in Herne Bay, support Dr Spinks' thoughts.

He said: "Why it is more difficult to recruit in Kent and Medway is difficult to pinpoint.

"Personally we're in a spiral where the pressure on GPs' workload is very high, so we are feeling burnt out.

"People looking at taking the role of a GP may look the other way.

"Then there is the general outlook of negativity, criticism towards the job and with the lack of funding it leads doctors feeling burnt out which is unattractive to new doctors.

"And then you can't just grow doctors overnight. Training a GP needs around a decade, so having a problem today won't be solved come the new students in September.

"A change in mindset of general practice is needed. I think figures say GPs do 90% of work for the NHS with general hospitals doing more than 10%.

"But with the budget the numbers are almost flipped the other way".

'We have to make general practice more attractive and most particularly here in Kent and Medway...'

Despite the issues, Kent's general practices are doing their best.

Sukh Singh, director of primary care for NHS Kent and Medway, said: “GPs continue to work hard to see patients as quickly as possible and are committed to offering a positive experience.

“The latest general practice appointment figures show 804,528 appointments were carried out in Kent and Medway in June.

"Of those, more than 60% were face-to-face or home visits.

"We recognise it can sometimes be frustrating for people trying to access their GP, but we continue to invest in practices across Kent and Medway to improve access and experience for patients to all general practice services.’’