There has been a drop in the number of GPs working in the NHS despite Government aims to recruit more, figures show.
Provisional data from NHS Digital shows there were 34,050 full-time equivalent GPs at the end of December. This is 445 fewer than in September when there were 34,495.
The total GP headcount (full-time and part-time) was 41,475, down 390 on September.
The Government has a target to recruit 5,000 more GPs by 2020.
Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said: "These figures are a huge blow - especially considering the recent efforts we know have gone into building the GP workforce."
She said a drop of over 400 GPs was "dreadful when we so desperately need thousands more in order to cope with ever-growing patient demand.
"We need to turn the tide. The future of the health service and patient care relies on having a robust general practice, with enough GPs to deliver the care and services our patients need.
"It is clear that current efforts to recruit more GPs and make general practice an attractive profession must be stepped up further and we will continue to work with Health Education England and others to help wherever we can."
She added: "A key pledge in NHS England's GP Forward View was to deliver 5,000 more full-time equivalent GPs and 5,000 other primary care professionals by 2020.
"Despite today's figures being incredibly disappointing, this remains a goal worth fighting for, and we all must redouble our efforts to achieve it."
Dr Krishna Kasaraneni, GP lead for education, training and workforce at the British Medical Association (BMA), said: "These figures underline just how far we are from meeting the Government's own target of recruiting and retaining more GPs as we near the one year anniversary of the GP Forward View in England.
"Despite the constant promises from ministers that the GP workforce would be increased by 5,000, the number of full-time GPs has fallen once again while the overall number has stagnated.
"While there have been encouraging increases in other healthcare professionals in general practice, what we really need are GPs who can deliver more appointments and other front line services to meet rising patient demand.
"There is also a great deal of uncertainty as Article 50 is triggered about the future status of doctors and other healthcare professionals from the European Union.
"With almost half of the 10,000 EEA (European Economic Area) doctors working in the NHS considering leaving the UK because of the referendum result this could further reduce the number of GPs delivering care in the NHS.
"The NHS is at breaking point and it is not acceptable for this recruitment and retention crisis to be allowed to get worse."