General practice faces implosion as 4% uplift falls short, warns GPC

General practice is facing implosion across England because of persistent underfunding and the crisis will deepen as the profession is forced to cope with less than 8% of the NHS budget beyond 2020, GP leaders have warned.

Dr Richard Vautrey: 'The government and NHS England have failed to invest in general practice’
Dr Richard Vautrey: 'The government and NHS England have failed to invest in general practice’

GPC deputy chairman Dr Richard Vautrey was responding to NHS England’s announcement of general practice funding allocations for the next five years.

General practice will receive an uplift of at least 4% a year - 25% in total on today’s funding over five years. But the profession's share of overall NHS spending will remain well below the 11% GP leaders say it needs.

By 2020/21 NHS England said, general practice could rise from 7.3% of current NHS spending to just 7.7%.

GP funding crisis

Dr Vautrey told GPonline that a GPC meeting this week heard reports from around the country of ‘general practice imploding’.

‘Many practices who thought they were just about OK suddenly losing a couple of doctors, being unable to recruit to replace them and almost overnight moving from stability to crisis. This then has a domino effect on the neighbouring practices, creating a vicious downward spiral.’

The fundamental cause of the crisis, said Dr Vautrey, was a ‘failure of government and now NHS England to invest in general practice’.

Officials, he added, were, ‘all too quick to fund hospital Trust's deficits with billions and yet fail to understand that to really solve the secondary care funding problems they need to build a solid general practice foundation - which needs at least 11% if the NHS cake not 7.5%.’

NHS budget

‘That small % change could make a massive difference and mean the difference between success or failure for not only general practice but for a sustainable NHS.’

NHS Alliance co-chairman Dr Mark Spencer welcomed the boost. 'This funding will go some way to relieve part of the pressure facing practices across the country', he said. 'However, general practice must not be viewed in isolation, and the news that community pharmacy is to receive a substantial cut in funding gives cause for concern.'

There must be increased funding for all primary care providers to cteeate an integrated service, Dr Spencer warned. 

NHS England’s five-year allocations came after the government agreed to increase NHS funding in England by £10bn a year by the end of the parliament.

But new analysis by the King’s Fund, Nuffield Trust and Health Foundation warned that health spending will rise just 0.9%  a year, ‘almost identical to the rate of increase over the last parliament’.

This, the thinktanks said, was because the government had changed the definition of the health spending ringfence to protect only NHS England’s funding, and was implementing 20% cuts in other areas such as health education and public health.

The report said: ‘The additional investment will be front-loaded with a significant increase in 2016/17 which is very welcome. However, much of this money will be absorbed by dealing with deficits among NHS providers and by additional pension costs.

'With much smaller increases in later years, the NHS will struggle to maintain services, let alone invest in new models of care and implement seven-day services. This places even more emphasis on the huge challenge of finding £22 billion in productivity improvements by the end of the parliament.’

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