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GP services need an extra £2.5bn

RCGP says extra investment needed to protect patient safety and the future of GP services

Mark Gould

Tuesday, 07 August 2018

GP services in England need a "substantial cash injection" of an extra £2.5bn a year on top of the £2.4bn funding already pledged, to protect patient safety and guarantee the future of the family doctor service, the Royal College of GPs (RCGP) says.

In its second Annual Assessment* of the government's GP Forward View, the College highlights areas where the five-year plan is falling short, particularly in the efforts to boost the GP workforce by 5,000 by 2020.

Since the GP Forward View was launched in April 2016, the review says the GP workforce has actually fallen by over 1,000 full-time equivalent GPs, according to official figures, meaning that more than 6,000 are now needed to meet the government's target.

While the promised funding of £2.4bn extra a year by 2020 is on track to be delivered, the College's report - which includes the results of a survey of 1,216 GPs - says that GPs are just not feeling the impact of this extra investment on the frontline of patient care.

The College calculates that by 2020/21, investment in general practice could reduce to 8.9% of NHS health spend – which would be lower than the year before the GP Forward View was launched.

Since the GP Forward View was launched, prime minister Theresa May announced £20bn extra a year in real terms for the NHS by 2023.

The RCGP is now calling for £2.5bn extra a year to be ploughed into general practice services by 2020/21, bringing investment up to £14.5bn a year. This would constitute 11% of the overall NHS budget, bringing funding in line with what it was in 2005.

Despite its critical assessment, the College acknowledges that there are several key areas where progress is being made, including:

  • Plans for a state-backed medical indemnity for GPs in England,
  • more GPs in training than ever before
  • the establishment of the NHS GP health service, which is highly rated by its users
  • the introduction of practice-based pharmacists is on track to exceed its target of 1,500 by 2020/21.
RCGP chair Professor Helen Stokes-Lampard, said the GP Forward View "remains the most constructive, indeed only, solution to tackling the intense resource and workforce pressures facing general practice, and it is making good strides in some areas".

But Professor Stokes-Lampard said it needs an urgent overhaul to address the pledges that are not progressing fast enough, particularly around retaining our existing workforce and reducing our workload; and to recognise the changing landscape of NHS funding, which now includes a promise of £20bn extra a year by 2023.

"General practice is the lifeblood of the NHS. GPs and our teams make the vast majority of NHS patient contacts for little over 9% of the overall budget, and in doing so we alleviate pressures in hospitals where care is costlier.

"The new secretary of state recently identified workforce and prevention as his top priorities. If he is serious about tackling the workforce crisis and keeping patients out of hospital, it is essential that the government invests properly in general practice.

"Of course, we need to work differently in general practice, but GPs and our teams across the country are struggling – and that makes innovation almost impossible. Our workload is constantly escalating, both in volume and complexity, and we are constantly firefighting, trying to keep up with demand, without enough resources to do so."

*GP Forward View Assessment of progress Year 2. A report prepared by the Royal College of General Practitioners, August 2018.

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