GP Forward View: NHS England must do more to save general practice, GPs warn

Rescuing general practice will take more than the GP Forward View, GPC chairman Dr Chaand Nagpaul has warned, as senior GPs hit out at a 'lack of detail' in the proposals.

Dr Nagpaul told GPonline that NHS England’s policy package, hailed by some senior GPs after its launch on Thursday, did not address all of the issues facing the service.

The GP Forward View which could see at least £2.4bn extra recurrent funding a year spent on general practice by 2020/21, was welcomed by RCGP chairwoman Dr Maureen Baker as the 'most significant announcement for our profession since the 1960s'.

But Dr Nagpaul said it was too early to say whether the package was enough without seeing the implementation. ‘It is not possible at this stage to make an informed view because all we have are intentions and figures on a document,' he said.

GP Forward View: full coverage

Dr Nagpaul, speaking following a GPC meeting held yesterday, said: ‘We don't believe that rescuing general practice is limited to the detail in the Forward View. We believe there are other measures that need to be implemented.’

The GP Forward View, he added, ‘has not addressed all the elements we have put forward in our Urgent Prescription for General Practice’. The GPC plan launched earlier this month includes proposals for a national limit on the number of patients GPs can see per day, to replace CQC inspections with targeted quality assesments, provide a protected half day a month for GP professional development, and to end annual contract negotiations.

The GPC chairman said the committee would reserve judgment on whether NHS England's package was enough to avert a threatened mass resignation campaign to see how NHS England’s plans are implemented in the coming weeks. GPonline reported survey findings earlier this year suggesting that three out of five GP partners in England were prepared to resign en masse if the BMA could not secure emergency support.

A special conference of LMC representatives voted in January for the GPC to canvas GPs’ opinions on a mass resignation campaign if there is no rescue package within six months.

GP funding

‘We were given six months to reach a decision and we need to now look through these proposals. We need to understand the detail and make sure there is proper delivery’, said Dr Nagpaul. ‘We will base our view on the adequacy of these proposals once the six months is up.’

Chairman of Doctors in Unite (formerly the Medical Practitioners Union) and GPC member Dr David Wrigley said there was ‘cynicism’ among GPC members about the policy package. ‘It was a lot less welcoming than the Royal College,' he said.

While it was too early to tell without seeing the implementation, Dr Wrigley said, GPs were concerned by the lack of concrete detail in the plan. ‘It doesn’t appear to offer immediate solutions,' he said. 'It talks a lot about money being available by 2020.'

Questions remain as to how much of the money announced in the plan was new money, and how it would be delivered to practices, said Dr Wrigley.

GP resignation

GPs, he added, were ‘very cautious and concerned that it may not be adequate’. He suggested that the plan may only be enough to avert mass resignations if there is ‘rapid implementation this year’.

‘Our urgent prescription for general practice is what GPC sees as the solution,' he added.

Dr Nagpaul said ‘unanswered questions’ remained about implementation. ‘For instance, money to enable GPs to work collaboratively: we need to understand how that will be implemented. What is important is not so much the headlines but how it will translate into reality and how it meets the needs of GPs.’

‘This is a template. Neither do we believe the Forward View is the end product. It is the beginning.

‘We have put forward additional measures in our urgent prescription proposals that still forms our central negotiating platform.

‘We believe the Forward View does contain significant positive proposals and new funding streams. It does recognise GP workload pressures. And we want to ensure the well intentioned, positive proposals are realised. But more needs to be done beyond the words of the Forward View.’

Meanwhile, Londonwide LMCs in a joint statement with the Resilient GP and GP Survival groups, said the plan ‘doesn’t instil most of us with the enthusiasm it seems to be causing elsewhere’.

‘This plan is very short on detail, and detailed immediate plans are what we need’, the groups said. ‘There is a recognition of the issues, but a lack of urgency in a dire situation.

‘If the government and NHS England were serious about maintaining high quality general practice for the rising population of the UK, this plan would include immediate emergency measures alongside the longer term vision. We look forward to seeing the GPCs next step in light of today’s report.'

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