Shaping the future of general practice

Looking to the future of the profession is a recurring theme at present. The College was at the forefront of pushing back against media speculation about plans to ‘nationalise’ general practice – and we continued our defence of the partnership model in our response to similar suggestions by think tank Policy Exchange.

RCGP Chair, Professor Martin Marshall said: “We are open to exploring new ideas about the future of general practice, but there has to be a very good reason for changing a model that works well for patients, the NHS and the tax payer.”

Last month Martin gave evidence to the first of five sessions that the Health and Social Care Committee is planning to hold as part of its own inquiry into the future of general practice.

The College had already submitted wide-ranging written evidence to the inquiry, but the focus of this session was the need to retain trained, experienced GPs in the workforce.

Jeremy Hunt asked Martin about recent BMA findings revealing that nearly half of GPs are planning to reduce their contracted hours and nearly a third are going to leave general practice altogether in the next year. He said: “Does that ring true with you? Is the profession in crisis?”

Martin responded: “Yes, it does ring true and it is a massive concern. I have been a GP for just over 30 years. I have seen ups and downs over that time in the status of general practice and general practice’s ability to do its job, but I have never seen things as low as they are now.

“If we are not able to provide the majority of care in the NHS – 90% of patient contacts happen in general practice; if we are not able to serve our communities, and if we are not able to do the job we do in protecting the rest of the NHS so that services are used judiciously and when they are required, that is a really big crisis.”

He added: “Our own College survey showed that 60% of GPs said that their mental health had suffered in the last year; 34% of GPs said that at least once a week they are fearful that they cannot do their job, not even providing safe care for their patients; and 34% of GPs said that they planned to retire in the next five years. That would mean 14,000 fewer GPs than we have at the moment. We are likely to be losing more GPs than we are recruiting at the moment, and that is a massive crisis.

“Essentially, the demand and the need for general practice services is greater than the supply,” he said.

In summing up his evidence Martin spoke about how vital general practice was to the overall success of the NHS. “There has to be hope for general practice, otherwise there is no hope for the NHS,” he said.

“We need to be honest with ourselves and say that we have reached a state in this crisis where we need to be working really hard on long-term solutions.”

In concluding the session, Mr Hunt said: “We have heard loud and clear that unless we have a long-term plan to give hope that the capacity of the system starts to match the demand on GPs’ time... we are not going to give credible optimism for the future to the new generation of GPs. That is certainly something we want to think about as a committee.”

The College will continue to campaign for solutions to the intense workload and workforce pressures facing GPs across the UK. •