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  • GP trainee round 1 recruitment increases 10%

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GP writingMay 11 2016

General practice consultations have increased 15% over the past five years, three time the rate of increase in the number of GPs (4.75%).

There has been a 13% increase in face-to-face consultations and a 63% growth in telephone consultations, the King’s Fund has said. The greatest increase in consultation rate, 28%, has been among patients in the over-85 group who are more likely to have more than one chronic condition.

In addition, “the move to transfer care closer to patients’ homes hasn’t been coupled with the equivalent transfer of resources to primary care, again increasing the pressure on GPs.” The scale of the recruitment and retention crisis is demonstrated in new research which found that “five years after qualifying, only one in 10 new GP trainees plan to be working full time seeing patients in general practice.

“GPs are also retiring earlier and in greater numbers: between 2009 and 2014, 46% of GPs leaving the profession were under 50; between 2005 and 2014 the proportion of GPs aged between 55 and 64 leaving doubled.”

The concerns are raised in a new King’s Fund report, ‘Understanding pressures in general practice’. It has analysed 30 million patient contacts from 177 general practices between 2010-11 and 2014-15. It notes that primary care funding as a share of the NHS overall budget fell every year, from 8.3% to just over 7.9%.

Among the recommendations made in the report are:

  • general practice should be placed at the heart of new sustainability and transformation plans to ensure that the voice of general practice is heard and acted on;
  • developing new and innovative models of general practice (for example, multispecialty community providers) should strike a balance between the benefits of working at scale through federations and networks and making sure services are responsive to local people;
  • designing a workforce strategy through Health Education England should support sustainable careers for GPs and their fellow team members, promote sustainable and fulfilling options for development and recognise changing career preferences.

Beccy Baird, Fellow at The King’s Fund and lead author of the report, said: “Investment alone won’t help the crisis in general practice. To avoid the service falling apart, practical support to do things differently is crucial and must be underpinned by an ongoing understanding of what is driving demand and activity. Only then will working in general practice be an attractive proposition and ensure the service remains at the heart of the NHS.”

Dr Maureen Baker, RCGP Chair said the report “provides cold hard facts that confirm what the College has been saying for years – that general practice is suffering under the unsustainable pressures of rising demand and a diminishing workforce.”

NHS England’s recent GP Forward View had provided “long overdue recognition” of general practice teams’ role. “But it was also an acknowledgement of the devastating impact of a decade of chronic underfunding for general practice,” she said.

“Moving forwards it is vital that data collection for primary care is brought on a par with secondary care. We need consistent and regular data reviews to provide up-to-date information on activity in general practice in order to ensure we don’t end up in this situation again.”

Dr Chaand Nagpaul, BMA GP committee chair, called on the Government to “implement an immediate rescue plan to protect and secure the future of the family service across England.”

He added: “This well-researched report provides more tangible evidence of the scale of the increase in GP workload which has totally outstripped GP services’ capacity to deliver effective patient care. It reinforces the BMA’s urgent prescription campaign calling for action to address the crisis in general practice.”

Katherine Murphy, Chief Executive of the Patients Association, commented: “Sadly these are not surprising statistics. The picture they paint is one that the Patients Association has seen time and time again. The drive for the public to be treated in the community has placed great pressures on the GP workforce and the allied professions. The Government must now address workforce planning.

“This latest report backs up our view that increased life expectancy means that GPs often see patients suffering from complex morbidities which require increased time and treatment. A shortage of full-time GPs, coupled with greater demands on their time as a result of an ageing population, means that the deterioration of patient care will only continue.”

Links:

King’s Fund announcement

King’s Fund report ‘Understanding pressures in general practice’

RCGP response

BMA response

Patients Association response

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