Millions of patients across the UK are being left without a GP at night, an investigation has revealed.
At least six health boards were forced to operate out-of-hours services without a single family doctor on occasion last year.
Sick patients were tended to by paramedics or an experienced nurse instead, health bosses admitted.
A national snapshot shows the number of night shifts where a doctor was unavailable has almost trebled from 57 in 2017 to 146 in 2018.
At least six health boards were forced to operate out-of-hours services without a single family doctor on occasion last year (file photo)
Meanwhile, serious incidents in out-of-hours care – where care has fallen way below that expected – have risen by a quarter.
Experts have blamed a shortage of GPs and lack of cash to tempt already overworked doctors into covering antisocial hours.
'The GP workforce across the United Kingdom is under severe strain, with the number of doctors continuing to fall, despite repeated government pledges to recruit more,' said Dr Richard Vautrey, of the British Medical Association.
'Combined with rapidly increased demand from a population with more complex health needs, this staffing shortfall means workload has reached unmanageable levels.
'Given the increased workload, it is no surprise that many GPs do not have the capacity to do additional overnight shifts.' Budgets for out-of-hours services have flat-lined, while the number of patients needing to be seen has increased, he added.
'Consistent and sustained investment in GP services combined with renewed efforts in recruitment are absolutely vital to deliver safe services,' Dr Vautrey said.
The figures follow an investigation by GP magazine Pulse. Of the 79 health authorities which responded to the Freedom of Information requests, seven admitted to having to run at least one shift with no doctor in the last two years because of staffing pressures.
The majority occurred at one of three regions in Wales, alongside two clinical commissioning groups, or CCGs, in England and two in Scotland.
The number of night shifts where a doctor was unavailable has almost trebled from 57 in 2017 to 146 in 2018 (file photo)
Hywel Dda University Health Board, which covers 384,000 patients, admitted it had no GP cover 125 times last year – almost three times the 42 times it operated without a GP in 2017.
In England, two CCGs reported struggling to fill out-of-hours shifts in 2018. Tower Hamlets, which looks after 331,000 patients in east London, experienced the problem