Four out of 10 patients are regular visitors, the study found. And it highlighted that a large -proportion of GPs’ workload was taken up by these patients. Professor Evan Kontopantelis, of the University of Manchester, said: “This is the first study to show that -frequent attenders, the top 10 percent of -consulters, have largely and -progressively contributed to increased workload in general practices across the UK over the last 20 years.”

       Professor Martin Marshall, chairman of the Royal College of GPs, called on the Government to increase personnel and resources.

       He said: “We urgently need the Government to make good on its promise of 6,000 more GPs and 26,000 more members of the practice team – as well as introducing measures to tackle the ‘undoable’ workloads so we’re able to deliver the care our patients need, including spending more time with them where necessary.

       "As well as having more patients than 20 years ago, GPs and our teams are seeing more patients who are living with multiple, long-term conditions, who often require care and services more frequently.

       “As this research suggests, this is increasing the complexity, as well as volume. GPs are working under intense pressures. These existed before the pandemic – the crisis has only exacerbated them.”

       The study defined frequent attenders as those who visited their doctor more than 90 percent of all other patients in the same practice. The number of their consultations doubled in the past two decades according to the study, which looked at more than 160 million visits from 12.3 million patients in 845 general practices between 2000 and 2019.

       The research, published in BMJ Open, found GPs were carrying out more appointments over the phone and online, but for frequent attenders face-to-face consultations continued to increase.

       Professor Aneez Esmail, co-author of the report, confirmed: “Frequent attenders are responsible for nearly -- 40 percent of consultations.”

       Fellow researcher Dr Maria Panagioti said it underlined the need for multi-role staff. She said: “Having multi-disciplinary teams is necessary to meet a wide range of needs through a range of ways such as remote consultations. Frequent attenders may have special health and social care needs.”

       Prof Marshall said continuity was key to patient care, but this has been increasingly been compromised by workload and staffing pressures.

       He added: “We’re able to deliver the care our patients with complex health conditions need because of the relationships we’ve built with them over time. [But] being able to offer longer appointments means being able to offer fewer overall.”