The GP substitute will see you now

An army of more than 20,000 physios, pharmacists and paramedics are to be recruited in England to work alongside under-pressure GPs, NHS bosses say.

The new staff will work with GPs, taking responsibility for some of the 300 million bookings made with practices each year.

They will also provide continuing care to patients in the community.

NHS England said this should allow GPs to spend more time with the sickest patients.

The average appointment lasts about eight minutes, which GPs say is not enough time to deal with the complex issues an ageing population presents with.

NHS England chief executive Simon Stevens said: "It represents the biggest boost to general practice in more than 15 years, giving patients more convenient services at their local GP surgery while breaking down the divide between family doctors and community health services."

GP leaders have warmly welcomed the move but warned extra doctors were also needed.

There are currently just over 34,000 GPs working in England, alongside 11,000 practice nurses.

Despite promises to recruit more GPs, the number of full-time equivalents working has actually fallen by 400 in the past three years.

The Royal College of GPs estimates the nation is 6,000 GPs short of what it needs.

The changes have been announced as part of a five-year contract brokered with the British Medical Association.

It is being funded by the extra £4.5bn that will be invested in community services by 2023 under the terms of the 10-year NHS Plan published earlier this month.

GP practices are being funded to recruit some of the staff directly.

In the future, each practice should have its own pharmacist, to carry out medicines reviews, and a social-prescribing link worker, who will be able to link patients with everything from exercise classes to lose weight to arts and dance groups to help with mental health problems.

But community services are also being reorganised as part of the 10-year plan, with the creation of primary care networks spanning several GP practices.

Many of the extra staff will work in these teams, providing an extra layer of services to patients.

By 2023-24, there should be 22,000 extra physios, pharmacists, paramedics and link workers in place.

But Nigel Edwards, of the Nuffield Trust think tank, said the NHS may find that hard to achieve.

"We need to hear more about where these staff are coming from - after all, many parts of the NHS have their own serious shortages," he said.

As the changes have been introduced as part of a new contract, the profession is fully behind the plans.

BMA GP leader Dr Richard Vautrey said he was "confident" the new deal would benefit both patients and doctors.

"Recent years have seen hard-working family doctors deal with an overstretched workforce doing their best to meet rising demand from patients suffering more and more complex conditions," he said.

Prof Helen Stokes Lampard, who chairs the Royal College of GPs, said these new staff would become "high-skilled members of the GP team".

But she added: "Our prime objective must remain the recruitment and retention of thousands more GPs."