09.03.16
DH and NHS given until end of year to set out strategy for tackling GP crisis
The government must set out plans to tackle the GP crisis by the end of the year, the Public Accounts Committee (PAC) has said in a new report which found that the staffing gap is creating increasing difficulties for patients accessing care.
In its new report, the PAC reiterated that more GPs are leaving the profession and not enough are being recruited, and that access to GP appointments is uneven, with patients who are young, from a minority ethnic group or living in a less affluent area less likely to be able to make an appointment.
It said the Department of Health and the NHS must set out plans to reduce the number of GPs leaving the profession, how they aim to attract more GPs to return to practice, and establish the best incentives for attracting new recruits to general practice.
The influential group of MPs want the organisations to report back on their progress meeting these targets and fulfilling their goal of 5,000 more GPs by 2020 in December 2016.
Meg Hillier MP, chair of the PAC, said: “There is a looming crisis in general practice. For too long staffing levels have failed to keep pace with the growth in demand and too little has been done to close the gap.
“Experienced GPs are quitting while training places go unfilled; there are alarming variations in the experience of different groups of patients, and in some cases even basic information is hard to find - piling additional pressure on other parts of the health service.
“These are serious problems requiring serious solutions.”
Lack of GPs
As we have known for some time, GP staffing levels are not keeping pace with the demand on services, with the number of consultations growing by an average of 3.5% a year in 2004-15, compared to just 2% growth in GP levels.
A recent BBC FOI request found that there is a 7% vacancy rate for doctors.
The report found that in 2014-15 12% of patients reported a poor experience making an appointment, compared to 8% in 2011-12.
The proportion of patients saying it was not easy to get through to their GP practice on the phone increased from 19% to 27%. Also, increasing proportions of GPs of every age group are leaving the profession, with the amount in the 55 to 64 age group doubling.
Factors causing this include frustration at administrative burdens, difficulties communicating with other parts of the health service, and attractive pensions for older GPs.
A National Audit Office report found GP morale is at its lowest since 2001.
According to a recent Health Foundation report, nearly a third of GPs are planning to retire or switch careers in the next five years.
A British Medical Association survey also found that 10.4% of GP practices are financially unsustainable, 37.3% had doctors who are planning to retire and 8.6% had doctors who are planning to leave UK general practice.
Recruitment is also a problem, with 12% of GP training places unfilled in the past year and Health Education England recently admitting that it may miss its recruitment target this year.
Dr Maureen Baker, chair of the Royal College of General Practitioners, which gave evidence to the PAC, said: “We are pleased that the Public Accounts Committee have listened to the College and recognised the enormous resource and workforce pressures currently facing our profession.
“GPs and our teams are making an estimated 370 milliom patient consultations a year – 60 million more than five years ago – to meet the increasing demand of our growing and ageing population, yet the number of family doctors over this period has remained relatively stagnant.
“This toxic mix of increased demand and plummeting resources is leading many established GPs to leave the profession, and not enough medical students are choosing a career in general practice to take their place.”
Unequal access to appointments
Most deprived areas tend to have the fewest GPs and nurses per 100,000 people, making it harder for patients to get an appointment, and this is likely to get worse because a higher proportion of older GPs work in urban and deprived areas are likely to retire in the next few years.
Younger people, full-time workers and people from ethnic minorities are most likely to have difficulties getting an appointment with their preferred doctor. For example, 19% of Asian patients were unable to get an appointment, compared to 11% of white patients.
The report recommended that by the December 2016 deadline, NHS England must develop a strategy for identifying and sharing best practice on access to general practice, including on how to improve access for patients from minority ethnic groups, review the effectiveness of its incentives to attract staff to understaffed areas.
NHS England recently confirmed that it is offering a £20,000 bursary to send 100 GPs to unpopular regions.
The PAC also said that the NHS should set out the minimum level of information that all general practices should provide to the public to help them access services easily, monitor practices’ compliance annually and, with the Department of Health, publish a plan for improving the information they have on demand, activity and capacity in general practice.
An NHS England spokesperson said: “We will soon announce more plans aimed at supporting GPs, tackling workload and ensuring high quality primary care remains at the forefront of NHS services”, adding that the NHS had recruited 5000 full time equivalent GPs in the past ten years and was already improving recruitment through a £10m investment and measures such as the ‘There’s nothing general about general practice’ campaign and a £31m fund to employ clinical pharmacists to take the burden off GPs.
A Department of Health spokesperson: "We are taking wide-ranging action to improve GP access as part of our commitment to a safer, seven day a week NHS" and that the promised 1% pay rise for NHS staff would attract more GPs.