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Reforms needed to relieve 'unsustainable pressure' on primary care

Primary care needs urgent reforms to meet changes in demand, the Health Select Committee has said in a new report.

The report says that primary care is under “growing and unsustainable pressure, exacerbated by a lack of resources”, with funding declining in real terms since 2006.

The report also says that the traditional primary care model of 10-minute appointments during the working day is not enough to meet the needs of a population who increasingly suffer complex conditions that need more treatment, and working lives that prevent them from accessing a GP.

Dr Sarah Wollaston MP, chair of the committee, said: “If we are going to provide the best possible care for people living with increasingly complex long term conditions, then primary care has to be able to change. We need to allow for longer appointments and for people to be cared for by a wider range of professionals.”

The committee said that while it welcomed the principle of extending primary care hours, the government should bear in mind that there is likely to be more demand for care in the evenings and on Saturdays than on Sunday and should test the seven-day NHS in pilot schemes before implementing it.

The report also recommends a new model of primary care, warning that 10-minute appointments mean that patients can only discuss one problem at a time and clinicians have to take a reactive rather than a proactive approach.

The report says that the government and NHS should “implement the necessary changes at scale and pace”, including widening the responsibilities of nurses, allowing patients to see a physiotherapist as a first resort and incorporating pharmacists into surgeries.

Janet Davies, chief executive and general secretary of the Royal College of Nursing, said: “The future of the NHS depends upon being able to manage long term conditions and prevent unnecessary and expensive hospital admissions.

“Primary care nurses are crucial to delivering this care, and MPs are right to have reflected our concerns about the lack of a sustainable long term workforce which makes that a very difficult task. The nursing shortage in England must be addressed as increased numbers of primary care nurses are vital in reducing pressure on an overloaded system.”

The report also has a number of recommendations for improving primary care, including better continuity of record keeping and better use of technology such as online consultations.

The report comes as the new General Practice Forward View from NHS England, published today, promised increased investment and staffing to help GP services.

The report rejected calls made by the British Medical Association and the Royal College of General Practitioners to abolish the CQC, saying they should work constructively with the inspection body instead.



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