A further fall in the number of GP practices in Northern Ireland is "deeply alarming", a body representing family doctors has said.
A new report reveals a loss of four GP practices in the past year to March 31, either through closures or mergers, and a cut of 27 (eight per cent) since 2014.
This leaves the number of GP surgeries in the region at 323.
At the same time the average number of registered patients per practice has risen from 5,500 in 2014 to 6,200 in 2020 - an increase of almost 13%.
Dr Laurence Dorman, chair of the Royal College of General Practitioners in Northern Ireland (RCGPNI), said the loss of more surgeries was "terrible news" for staff and patients.
"We have been telling government and health leaders for a long time that GPs are under immense pressure. They were under tremendous strain even before the pandemic," he said.
"Our survey of RCGPNI members last year showed we had a stressed workforce, with 32% of GPs saying they felt so stressed that they can't cope at least once or twice a week.
"When a practice closes for whatever reason it is incredibly difficult for everyone involved, especially patients. Generations of institutional knowledge about patients and their families can be lost and there also follows a ripple effect, where neighbouring practices become at risk of destabilisation."
According to the report, the health trust which has seen the greatest decrease in GP practices in the past six years is the Western, with numbers falling from 57 to 48. The Southern Trust has been least affected, down from 76 to 73 practices.
However, the number of GPs (excluding locums) has increased by 16% to 1,364 since 2014. Of these, over half (58%) are women, a notable shift since 2014 when only 46% were female.
The report also shows there are just over 2m people registered with a GP practice. Belfast has the highest number of patients at 431,000, while Lisburn and Castlereagh has the lowest at 118,000.
During 2019/20 over 50,000 new patient registrations took place and approximately 40,000 were removed from the registers.
Meanwhile, the Business Services Organisation processed payments of £285.8m towards the overall cost of GP services here, with an average payment of £143 per patient.
Dr Dorman added that, despite coronavirus "GPs are continuing to deliver high quality medical care and advice in very challenging circumstances".
He said: "Our health system in Northern Ireland will never be the same as it was before coronavirus.
"It was badly broken and inefficient, with patients sometimes waiting years for elective care, and so we welcome any reform of our health and social care system that will improve the patient journey."