General practice

Next government must be substance over style when it comes to general practice, says chief GP

Leaders at the Royal College of General Practitioners (RCGP) have urged political parties to focus on problem-solving rather than point-scoring, as the general election edges closer and waiting times remain at an “untenable and totally unacceptable” level.

The RCGP’s chair, Professor Kamila Hawthorne, has expressed concern that ‘vote winning’ may be front and centre of political thinking this month, leading to “gimmicky” and “unrealistic” targets that fail to address the root of the problems in general practice.

Less has been more

The RCGP says that rising and increasingly complex workloads — along with a stagnant full-time equivalent workforce — are the main causes of patient access issues.

To back this up, the royal college highlights data that indicates GP teams are delivering more with less resources.

In April 2024, GPs delivered 30.3 million appointments, which is nearly six million more than the same month in 2019 — but with around 880 fewer fully qualified full-time equivalent GPs than five years ago.

Despite many (45%) appointments being delivered on the same day of booking, 1.6 million patients still waited over a month.

This is partly down to the average number of patients per fully qualified GP continuing to rise, with the figure now at 2,294 — 154 more than 2019.

This is mirrored by a 34 percentage point decrease in satisfaction with GP services, according to the British Social Attitudes survey. Almost three-quarters (71%) of the dissatisfied respondents pointed to GP access as a main reason.

‘if general practice fails, the whole NHS will fail’

“Without immediate action, the future of general practice is at risk,” said Prof Hawthorne.

She added: “For whoever forms the next government this must be a ‘day one’ issue. The voting public wants to know what the winning party is going to do to ensure they can access safe, timely appropriate care from their local practice.

“It’s every bit as important as the long waiting times for hospital appointments, and if general practice fails, the whole NHS will fail.”

The avoid this, the RCGP has suggested seven steps, including:

  • Protecting patient safety by introducing a national alert system to flag unsafe levels of workload and enabling practices to access additional support
  • Ensuring patients get the care they need, closer to home, by increasing the share of NHS funding for general practice
  • Providing more support to patients in deprived communities
  • Ensuring every patient who needs to see a GP can do so quickly and safely by growing the GP workforce
  • Giving every patient access to a modern fit for purpose general practice building by investing at least £2bn in infrastructure
  • Freeing up GPs to spend more time with patients
  • Guaranteeing permanent residence for international medical graduates qualifying as GPs to make sure they can work in the NHS

“We don’t need gimmicky, unrealistic targets that might sound good on a paper and might win votes but will never work without enough GPs to deliver them,” added Prof Hawthorne.

“We need significant investment and further efforts to increase the GP workforce, especially in encouraging the brilliant GPs we already have, to remain in the profession or this situation will only get worse.

“In the run-up to polling day on 4 July, we urge all the political parties to read and take heed of what we’re telling them.”

Image credit: iStock

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NHE May/June 2024

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