Nurses are increasingly being used instead of doctors to run out-of-hours services, according to an investigation by Pulse.
Although accounting for just 6% of coverage overall, in some areas it is much higher - 30% at Warwickshire, 25% at Western Cheshire and 21% at Blackburn with Darwen, it found.
Of 600 GPs surveyed, 64% said their trust was cutting the number of GP shifts, while 69% said there were moves to replace on-call doctors with nurses and emergency-care practitioners.
As many as 71% of GPs said they did not support these moves, while half said out-of hours care had got worse since PCTs took over responsibility for running services in 2004.
Figures also showed that, at the top end, Wirral is spending £50.80 per patient each year while Lambeth is spending just £2.99 per patient.
Average annual complaints from patients since 2004 varied from 2.3 at Buckingham, to a high of 64 a year at Bournemouth and Poole.
A Department of Health spokesperson told Pulse it was in talks to attempt to improve out-of-hours care by persuading GPs to take back commissioning of services.
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