GPs could face 'collapse' as social care cuts drive up workload

General practice could face a 'sudden and cataclysmic collapse' as cuts to social care funding increase pressure on primary care, according to one of London's top GPs.

Dr Tony Grewal: social care cuts could trigger GP collapse
Dr Tony Grewal: social care cuts could trigger GP collapse

An imminent social care crisis could close nursing homes and put support for the elderly and disabled at severe risk, the Association of Directors of Adult Services (ADASS) warned in a letter to chancellor George Osborne last week.

The letter, signed by ADASS President Ray James, challenged the Chancellor’s claims that allowing local authorities to raise council tax by 2% and increasing the Better Care Fund would prevent adult social care budget cuts despite a drop in council funding.

The ADASS said support for vulnerable people was already in decline, citing a 28% fall in older and disabled people receiving council help between 2009/10 and 2013/14, and warned a £1.5bn increase in Better Care funding would not materialise until 2019.

GP workload

GPs have warned that the profession faces a significant knock-on effect as councils struggle to fund social care services in the face of rising demand from an ageing population and higher costs from the introduction of the government’s ‘national living wage’.

GPs will be the ‘carers of last resort’ for patients whose social services support is withdrawn, Londonwide LMCs medical director Dr Tony Grewal warned.

The profession’s workload will rise as it is forced to ‘deliver an uncontracted and unresourced service, to find an alternative mechanism for the service, or to support the patient in challenging the withdrawal of the service’, he said. They would also have to cope with the rise of long-term health conditions and morbidity that social care will no longer be able to manage.

GPs do not have sufficient resources or capacity to face this, ‘even if responding to such demands were appropriate’, argued Dr Grewal. ‘There is already a recruitment, retention and workforce crisis and there is a genuine risk of sudden and cataclysmic collapse if pressures continue to increase,’ he told GPonline.

Hertfordshire and Bedfordshire LMC chief executive Dr Peter Graves warned that GP funding could also be cut if commissioners were forced to redesign services to cope with cuts in social care funding. ‘Commissioners will have no option but to commission much more integrated services that fill the gaps created by the cut in social care budgets that may end up excluding GPs,’ he said.

This could lead to patients being removed from practice lists and managed by a new services, with resulting financial losses ‘potentially making practices unviable.’

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