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GP funding has reached dangerous levels

GPs face a million more people with long-term conditions as service is decimated, RCGP warns

Louise Prime

Thursday, 01 October 2015

General practice will face caring for an “explosion” of a million more people with life-threatening conditions within the next decade, at the same time as its funding has been decimated to dangerous levels, warned the Royal College of GPs this morning. College chair Dr Maureen Baker said general practice is the NHS’s only hope for meeting the UK population’s growing and changing needs – but it can only do so with substantial investment and thousands more GPs.

Dr Baker told delegates in Glasgow for the RCGP Annual Primary Care Conference that the latest analysis by the College forecasts one million more people living with more than one serious long-term, life-threatening condition by 2025, which will cost general practice in the NHS up to £1.2bn every year. The College also predicted that on current trends, it would take another 65 years for general practice’s share of the NHS budget even to reach levels of a decade ago, when far fewer people were living with multimorbidities such as cancer and diabetes.

She said: “It is a great testament to modern medicine that nowadays we are much more likely to prevent or treat diseases that in the past killed people so early in their lives. GPs have played a pivotal role in this transformation.

“But this success has brought with it a whole new set of challenges to which the NHS is currently struggling to respond.”

GPs and their teams have 370m consultations a year, up by 60m from just five years ago, thanks to a sharp rise in people with multiple long-term conditions. Dr Baker again highlighted the "paradox" of general practice currently accounting for 90% of NHS patient contacts across the UK, while receiving only 8.33% of its budget (8.45% in England). She pointed out that as the most cost-effective place to deliver complex care to patients is general practice, allowing its funding to decline “to such dangerous levels” is “throwing money down the drain”.

She warned: “We need an NHS that’s properly set up to meet the complex clinical needs of people in the 21st century. We need an NHS that can achieve this in a cost-effective way, supporting people to stay out of hospital and live as independently as possible. And we need an NHS that is caring and person-centred, because we know that clinical need so often overlaps with psychological and social factors.

“We all know what this is – it’s called general practice!”

Dr Baker went on to dismiss the English Government’s preoccupation with seven-day working as “living in cloud cuckoo land” and a “recipe for disaster” with current resources. She warned health secretary Jeremy Hunt, and David Cameron: “If you don’t shore up existing GP care as your top priority, not only will you not get a seven-day service, but you won’t have a five-day service either – because you will have completely decimated general practice.”

She made five demands that she said have the potential to put general practice on a secure footing for patients and GPs, and restore it to the exciting and stimulating career option that it once was:

  • A costed plan to ensure it receives 11% of the overall NHS budget with ‘an immediate injection of £750m of additional core funding in the next financial year’.
  • For concerted action to increase the GP workforce, including financial incentives to attract medical students and sanctions against medical schools that fail to abolish bias against general practice.
  • An urgent rethink on the bureaucracy of Care Quality Commission inspections.
  • Maximising use of increasingly mobile and miniature technology.
  • Freedom to innovate – with a focus on promoting GP-led new models of care.

Dr Baker insisted: “General practice is the Obi Wan Kenobi of the NHS – our only hope, but this can only be the case with substantial investment in our service and thousands more GPs right across the UK.

“This is the only way we can transform our NHS so that it meets the changing needs of patients.”

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