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GP strategy pledges £2.4bn investment and more doctors

NHS England has pledged to tackle the crisis in GP provision in its General Practice Forward View strategy, published today.

In his introduction to the report Simon Stevens, CEO of NHS England, said that the number of hospital specialists has grown three times faster than the number of GPs in the past 10 years, despite the important role of GPs in caring for an ageing population with complex and long-term health needs.

The report promises that investment in general medical practice will increase by £2.4bn overall by 2021 and £322m this year, as well as creating a £508m Sustainability and Transformation package to help struggling practices in the interim. It also sets a target of increasing GP recruitment to 3,250 every year.

Stevens said: “The vital thing is to roll our sleeves up, get practical, and together begin to make a tangible difference, now, for practices and for our patients.”

A recent Health Foundation report found that the UK tops the international table for GP stress and that 92% of GPs reported they were so overworked their appointments lasted for 15 minutes or less.

Mark Stocks, partner from public sector assurance at Grant Thornton UK LLP, said: “The £2.4bn injection by the NHS for GP surgeries will provide much needed extra resource for local health services. Doctors have been concerned with the growing workloads placed on the profession, and this move will hopefully stem the number of GPs leaving the NHS, and make the job more attractive to others.”

The strategy also sets a target of increasing GP recruitment to 3,250 a year in order to support the NHS’ target of recruiting 5,000 more doctors by 2020. This will include 500 recruited from overseas and 500 doctors who have left general practice being encouraged to come back.

The British Medical Association warned recently that 10% of GP practices are financially unsustainable and 46% of GPs are planning to leave or retire in the next five years.

The Royal College of General Practitioners (RCGP) welcomed the reforms, which they said implement ideas they have been campaigning for in their ‘Put patients first: back general practice’ campaign.

Dr Maureen Baker, chair of the RCGP, said: "For too long GPs – and our members – have been undervalued, underfunded, and not recognised for the essential role we play in keeping the NHS sustainable and safe for patients. We genuinely hope that today's news marks a turning point for general practice and the health service.”

The report also introduces a new promise of 3,000 additional mental health therapists to work in primary care by 2020, or one therapist for every three GP practices, following the government’s commitment to invest in mental healthcare.

The NHS said they will invest £16m in mental health services to help GPs cope with stress after a survey showed that over 80% of doctors know colleagues who are suffering from mental health problems.

Measures to reduce pressures on general practice include a £30m ‘Releasing Time for Patients’ capacity release programme, standard contract measures to stop hospitals transferring work to GPs, and a move to a maximum interval of five years between inspections by the CQC.

Professor Steve Field, the CQC’s chief inspector of general practice, said the review set out “inspiring vision for the future of general practice” that he hoped would lead to an improvement in GP services.

He said that the CQC would help deliver the Forward View as they moved towards existing plans to implement a regulatory model of inspection.

Professor Field said: “We have always been clear that regulation across all sectors must continue to be independent, proportionate and driven by patients’ best interests. Our inspections are allowing us to gain a deep understanding of the quality and safety of general practice that we have never had before in this country and they are leading to real improvements in care.”

The 66% cap on NHS England funding for redevelopments of GP premises is to be removed so that the NHS can fund 100% of redevelopment costs.

It will also try to promote the use of IT to make GP practices more efficient, as recommended in a recent report from think-tank Reform. The investments include increasing CCG funding allocations for technology by 18% and creating a £45m national uptake programme for online consultation systems.

Niall Dickson, chief executive of the General Medical Council (GMC), said: “GPs in England are under huge strain at the moment and it is vital that we keep the workload associated with regulation to a minimum. 

“This plan commits us, the Care Quality Commission and NHS England to work more closely together to reduce and align the requirements that we place on general practice. It is important that we address any unnecessary overlaps as well as gaps.”