GP leaders warn of ‘break-point’ for the profession

The Royal College of GPs said it recognises that NHS England is making progress in delivering many of its 100 or so pledges contained within the plan for the sector, and that the commitment to spend an extra £2.4 billion each year on general practice by 2020/21 is on track.

However, the General Practice Forward View is falling short on its crucial pledge to build the GP workforce by 5,000 more full-time equivalent family doctors by 2020 to help meet growing demand for services, as figures show that actual numbers have dropped since September last year.

Moreover, research conducted for the College by Ipsos MORI among RCGP members reveals that 39 percent of GPs say they are unlikely to be working in the profession in England in five years, which could signal breaking point for the profession unless progress in delivering the GP Forward View is accelerated, it warns.

On the plus side, data from Health Education England show that the number of doctors entering GP specialty training is set to be higher this year than last, with 2,927 already signed up, so the College says it is optimistic that the target of 3,250 can be met in 2017. But it also stressed the need for more action on retaining existing GPs in the profession.

"It takes at least three years in specialty training for new doctors to enter the workforce as independent consultant GPs so whilst it’s fantastic that more foundation doctors are choosing general practice this year, if more people are leaving the profession than entering it, we’re fighting a losing battle," noted RCGP chair Professor Helen Stokes-Lampard.

"Above all else we need to see efforts stepped up to keep hard working, experienced GPs in the profession, and the best way to do this is to tackle workload pressures and improve the conditions under which all GPs and our teams are working."

Dr Richard Vautrey, the British Medical Association's GP committee chairman, told the media that the government’s promise of 5,000 extra GPs is now "unachievable".

"In order to create a stable GP workforce, the government must expand the number of GPs entering the profession, and urgently address the underlying issues, particularly the unsafe workload pressure, behind the recruitment and retention crisis in general practice."

Other concerns
Other areas of concern include the slow progress in finding a long-term solution to soaring medical indemnity costs, the gaps in what some initiatives are setting out to deliver and GPs’ views on what is needed, and finding better solutions to reducing GP workload to a management level.

Also, while changes have been made to the GP contract to improve interface between primary and secondary care, "very few GPs have noticed a difference" and it remains is unclear whether these standards are being uniformly implemented.

On a more positive note, £17.2 million was invested in a practice resilience programme to help struggling and vulnerable practices, which is more than promised in the first year of the plan, and a pilot scheme to support practices in encouraging self-care in patients with long-term conditions in order to reduce workload has begun across 50 sites.

The College says it has also received assurances from NHS England that proper funding allocations have been made for general practice this year, meaning that recurrent investment is on track to be increased by £2.4 billion a year by 2020/21.

"There has been a lot of good work going on – and it’s great to hear that additional funding for our service is on track. We are certainly not suggesting that NHS England, Health Education England and others have been resting on their laurels – we know they are committed to making things better in general practice," Professor Stokes-Lampard said.

"But it is clear that there is a lot more to do, specifically around building our workforce. We need the GP Forward View delivered in full and in time, and if that involves a re-think of some strategies, then so be it – it’s necessary and in the best interests of GPs, the wider NHS and our patients."