Unstable funding has left practices on 'path to destruction', warns London GP leader

New models of care outlined in NHS England's Five-Year Forward View cannot succeed unless core GP funding is stabilised, a leading London GP has warned.

Speaking at the Londonwide LMCs conference on Wednesday, Londonwide LMCs chief executive Dr Michelle Drage said commitments to invest in general practice and stabilise core GP funding over the last two years had not been met, spelling disaster for new care models.

She said: ‘People are talking about new models, when actually the old model kind of worked. We just need people to actually be there for our patients and ourselves – and we don’t have enough people joining, putting the future of the GP model in question.

‘This is a bit of the Five-Year Forward View you never hear - right up front in the beginning: over the next five years the NHS will invest more in primary care, while stabilising core funding for general practice nationally over the next two years.

GP funding

‘That two years is up in October – who feels they’ve been stabilised? No – so words mean what they say and there’s been no stabilisation. You can’t have new models working effectively without stabilisation or health sustainability.

‘Six months to go and PMS practices have been defunded, GMS practices are on a path to seven years of destruction – this is not sustainability, this is not stabilisation.’

She declared a ‘state of emergency’ in general practice, warning that the profession was ‘at breaking point’.

GPs are ‘boiling frogs’, she added, and had been tolerating rising pressures – but now was the time to jump out of the pan before it was too late.

Surveys have shown that one in three practices have GP vacancies and 10% believe they are financially unsustainable.

GP workforce

Two fifths (37%) of practices have a GP planning on retiring in the next 12 months and 9% have one considering leaving UK general practice, said Dr Drage.

‘Doctors are leaving, nurses are leaving,’ she told delegates. ‘Patients are increasingly unhealthy, with multimorbidity that was confined to people in their 60s and 70s now actually being seen in our most deprived areas in their 40s and 50s.

‘High levels of economic deprivation and accompanying social factors are driving ill health. We know this stuff, but not enough is being said.’

She called on GPs to push back against workload that fell outside core GP responsibilities, focus on what’s necessary for care and get patients on board regarding the pressure facing GPs.

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