The UK is a long way short of targets for recruiting more GPs, according to a major analysis published today.

NHS professional standards are being “hollowed out” as highly-trained clinicians are replaced by clinical support staff, according to the Health Foundation analysis. Nursing recruitment is now the service’s biggest problem and managers have recruited heavily from the Philippines and India amid growing reluctance among EU staff to work in the UK, the Foundation says.

It came as the Royal College of Nursing published its own survey showing nursing staff at “breaking point” over their current workloads. The Health Foundation analysis of the last year shows increases in numbers of doctors and nurses – but that this is failing to keep pace with demand or targets.

GP numbers fell during the year of study – by 453 – in spite of success in improving trainee numbers, the Foundation found. This makes it “almost impossible” to achieve an earlier promise of increasing numbers by 5,000 by next year, it says.

The Foundation says the service needs to recruit 5,000 overseas nurses a year – and may have succeeded in the last year with 3,118 from the Philippines and 1,791 from India joining the nursing register. But there is no guarantee they will all serve in the NHS, the Foundation says.

Anita Charlesworth, from the Foundation, said: “As the general election draws closer, the staffing crisis is the make or break issue for the NHS. Nursing shortages continue to deepen and are inevitably impacting on the front line.

“Services are being forced to make do with shortfalls of increasingly pressurised nurses and rely on less-skilled support staff to pick up the slack. Clinical support staff play an incredibly valuable role in the NHS if they are supported in a well-planned way, but these trends appear to be largely unplanned, reflecting the failure to recruit enough nurses. Operating without a plan means there has not been enough consideration of the impact such changes might be having on patient care.

“Our projections show that, with concerted policy action, the NHS might be able to retain around 11,000 more nurses by 2023/24 than at current trends. The reality is, whatever happens with Brexit, we will need more nurses from abroad than we are currently attracting to keep the NHS running.”

Niall Dickson, chief executive of the NHS Confederation, said the report was “sobering reading.” He said: “With over 100,000 vacancies, additional pressure is being heaped on support staff to plug the gaps – this is neither fair nor safe.”

* According to the RCN survey, 61% of nurses say they are too busy too provide the level of care they would like for patients – and just 51% are happy with their working hours. Some 65% had suffered verbal abuse. Confirming the Health Foundation analysis, many healthcare assistants said they were being asked to undertake the duties of registered nurses.