The London Assembly health committee, chaired by GP Dr Onkar Sahota (Lab, Ealing and Hillingdon), said as the capital’s largest landowner, the mayor should ‘play a major role’ through the planning process to resolve the ‘crisis’ in GP premises.
In a new report, Access to GP Care, published on Tuesday the committee said the mayor should work with NHS England to improve the primary care estate.
It also called on the NHS to work with boroughs to ensure infrastructure benefits from section 106 planning agreement funding and from the community infrastructure levy.
‘The NHS needs to consider playing a more active role in London’s planning system,' the report said, calling for an investigation into whether new practices need to be opened.
The call in October by the London Health Commission, chaired by Lord Ara Darzi, for a £1bn capital investment in premises to help shift care into the community, needed further consideration, Dr Sahota’s committee said.
The committee noted that the withdrawal of MPIG ‘may remove the incentive of opening a practice in more deprived areas’ and in some cases it may render the practice economically unsupportable’. It called for funding changes to be monitored to ensure funding is distributed to support and encourage practices in deprived areas.
The report there was ‘a case’ for NHS England to ‘consider developing a salaried GP service in London to extend the provision of service where needed’. This could also provide new career choices for newly qualified GPs, it added.
GP crisis point
Dr Sahota said: ‘London’s population is growing rapidly and we could reach GP crisis point soon. To improve patient satisfaction, we desperately need more GPs and better access to them. If we are to move more patient care from hospitals to the community, we must have the funding and infrastructure in place for increased general practice capacity – that means more GPs, increased morale, improved surgeries and easier access. There is clearly a supply and demand issue and something drastic needs to be done before we reach the tipping point.’
Londonwide LMCs’ chief executive Dr Michelle Drage said GPs were ‘encouraged’ by the report’s message that reform of general practice should be part of a wider coordination of in-community care, rather than a ‘piecemeal attempt to cut costs’.
She said: ‘The report’s recommendations echo our own calls for more support and recruitment into the profession.'
LMCs, she added, would work with the mayor, the London assembly, and NHS England ‘to improve capital and revenue investment in general practice to support and enable the shift of care into the community and away from acute hospital settings’.
Other recommendations to NHS England:
- Commission work to evaluate the reasons for low GP morale and how to attract new recruits.
- Review its IT strategy and the effect of technology on GP demandCommission general practice to explore alternative ways of working to ensure inclusive patient access.
- Review incorporate into its review of general practice, analysis of the effect of changes in general practice on wider primary and community care infrastructure.