This morning has been spent in a flurry of social media and emails about the #GPForwardView. The range of opinions has been from welcoming it as a 'turning point for general practice' to 'yes, but where is the rescue package?'. Yet again, our profession is divided.
This report is clever politicking. The government can, via NHS England, tell the nation that it is saving general practice at a time when under massive pressure due to the junior doctor strike. The RCGP has welcomed the report as our official professional body. But is it really doing what it says on the tin?
My four-year-old could tell you that the math don’t add up. The money is going to have to come out of the £8bn already promised to the NHS. Which is on top of the £22bn savings that have to be found. The £2.4bn will only take us back to LESS than the 2010 levels of funding for general practice and we will have to work harder, pay more staff and try to get hold of that money via complex processes.
There is a £322m primary medical care allocation mentioned for 2016/17. Isn’t this what we had already been told we were getting, so this is rebadging of money we have already been given? CCGs have no spare money, many are overspent and/or having to prop up secondary care trusts, so I am not sure how they are supposed to find £171m for the transformation fund.
We don’t have enough GPs. Is this plan going to make GPs soon-to-retire decide to stay on? I am not so sure it will. What will change to make their lives better in the next year? Nothing I can see. Will returners return? Perhaps, there may be more money for them.
Will locums be happy? No, there is to be a suggested cap on locum fees and practices will be obliged to report what they are paying, according to the report. What would have helped? Putting more money into GPs surgeries directly, to enable them to plan their staffing levels and ensure working conditions are as good as they can be.
General practice at scale
As expected, this plan is based around working 'at scale' and all the perceived benefits that will bring. Yes, there are definitely some, but a great deal of this money is being spent facilitating this change. GPs don’t have time to wee, let alone plan new ventures. Some vanguard sites are doing well, others are floundering. It's not a panacea for general practice and I worry that the authors of this report are forgetting the importance of smaller, well-run surgeries.
This plan is very short on detail and immediate detailed plans are what we need, otherwise there won’t be a general practice to fund in five years' time. What might have helped more? Increasing the global sum tomorrow and putting that money directly into practices who have time and time again proven that they are efficient, adaptable and can rise to any challenge set to them. Ensuring that indemnity is sorted out now, not a promise to do so in the future.
I really wanted to like this report, I have been waiting for it for long enough. Sadly, it has entirely lived up to my expectations.