Abandon 'sticking plaster' GP recruitment target, think-tank warns government

The government should abandon its target of recruiting or retaining an extra 5,000 GPs by 2020, a right-leaning thinktank has said.

In a new report on the future of general practice, Reform called the 5,000-GP recruitment target a ‘sticking plaster’ which will not solve the problems the service faces.

The report also called for an end to GP contracts awarded in perpetuity, to be replaced with time-limited contracts.

NHS England should conduct an audit of GP appointments, the authors recommended, to better understand how consultations can be delivered more efficiently by other clinicians and a recruitment and training plan built around that.

The report by Reform - a think tank set up in 2001 by Conservative MP Nick Herbert - concluded that between 27% and 50% of patients visiting a GP could be seen by another health professional.

GP workforce

Report co-author Alex Hitchcock said: ‘Employing 5,000 more GPs is nothing more than a sticking plaster for an out-of-date model. Bigger practices and new technology can deliver better access and stop millions of unnecessary A&E visits.’

The report calls for current GP funding streams to be replaced with outcomes-focused  contracts covering whole care needs for defined populations. Commissioners, it added, should fund service from integrated budgets.

Future contracts, the report recommended, should be for fixed terms of between five and 15 years, to encourage competition. GP practices should be encouraged to compete with private firms for the right to treat patients. Provider organisations could even be allowed to make hostile bids for other providers.

The report also claims to have new evidence of rising public demand for seven-day services. Data from a Hertfordshire GP consortium suggests that demand for weekend appointments increased from 40% in January 2015 to 80% in December.

It claimed 12m A&E and out-of-hours attendances resulted from patients' inability to arrange a GP consultation.

Seven days

But the RCGP challenged the reports conclusions. 'This support for seven-day general practice services flies in the face of our own research – and the fact that a number of surgeries that have piloted seven-day working have had to scale-down services due to a lack of patient demand at weekends', said chairwoman Dr Maureen Baker.

She added: 'Access to general practice services is undoubtedly important, but patients recognise that prioritising weekend and evening access must not come at the expense of access and services during normal hours. They have better things to do on a Sunday afternoon than have their ears syringed.

'Our polling has found that only 31% of patients felt it should be the priority, whereas two thirds of patients felt the Government should focus resources on improving existing services rather than delivering seven day access to general practice.'

Dr Baker said the government's 5,000 extra GPs target would be a 'step in the right direction' to properly resourcing current services, but not extending reoutine services over seven days.

'Many of the recommendations in today’s report cannot be done in most practices with the time and resources available. Relying more on practice nurses, for example, is impossible when many surgeries are struggling to recruit – and existing practice nurses aren’t simply sitting around waiting for patients to walk through the door, they are under just as much pressure as GPs.'

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