Patients – and the wider NHS – depend on the care of GPs in their local communities, but we have a severe shortage of family doctors and this will have a disastrous impact on future generations unless urgent action is taken to stem the tide.
Professor Roland’s report could prove to be a valuable lifeline to help rescue general practice from years of neglect and under-investment and ensure that we can continue to deliver good and safe care to our patients well into the future.
The report echoes much of what the college has been saying for a long time and we hope it will add grist to the mill in our campaign to increase funding for general practice and significantly boost the number of GPs.
The commission shows a lot of common sense, particularly in calling for a shift in funding from secondary to primary care."
We welcome the commission’s call for rapid implementation of the 10-point plan, launched jointly by the RCGP, NHS England, Health Education England and the BMA earlier this year to build the GP workforce.
We reiterate our call to the government to urgently deliver the 5,000 extra GPs in England it pledged prior to the general election – and to consider extending this to 8,000 which, in our opinion, is a more realistic target for meeting the needs of our changing population.
We must all work together – health bodies, government, and medical schools – to ‘recruit, retain and return’ as many new GPs as possible, so that we can meet rising patient demand without compromising the high standards of care that our patients are used to and deserve.
While the commission’s report is aspirational for the future of primary care, it also shows a lot of common sense, particularly in calling for a shift in funding from secondary to primary care.
General practice reform
By strengthening general practice, we alleviate pressure across the health service by ensuring that more patients are cared for close to home where care is cheaper and where our patients want it most.
But we recognise that general practice itself also has to adapt and change.
We welcome the report’s backing of new models of care, particularly federations, which the college pioneered, and which we are currently involved in mapping out across the country.
We are also open to widening the skill-mix in general practice, with the introduction of roles such as practice-based pharmacists to take on some of the tasks that do not necessarily need to be done by a GP.
These will never be a substitute for GPs so any new roles, such as medical assistants, must be properly piloted and evaluated to ensure that they can add value to patient care in general practice.
More than 90% of all NHS patient contacts are managed in general practice but the share of the NHS budget has fallen to an all-time low of 8.3%.
GPs and our teams are now conducting 370m patient consultations a year, 150,000 more per day than even five years ago.
Our patients are living longer and increasingly with multiple and chronic conditions, both physical and mental, so we are pleased that the commission has acknowledged that the standard GP 10-minute consultation is often insufficient.
But whilst the use of technology in healthcare is often hailed as a wonder-solution to the capacity problems we face, we must not be blind to its limitations.
Some technological advances are incredibly useful for both doctors and patients, but we are concerned that 'virtual' correspondence between GPs and our patients is unlikely to reduce workload and actually has the potential to increase it.
We therefore support the commission’s cautious approach to introducing email correspondence as a matter of course and its recommendations for piloting to ensure that this doesn’t add to workload overall.
This important report has the potential to be a game-changer if the government and others take heed and act on its recommendations. If this happens, we are confident that the benefits it delivers to general practice, the NHS and our patients will be immense.
We thank Professor Martin Roland and his colleagues on the commission for their work in so accurately capturing the scale of the challenges that lie ahead, along with the solutions for tackling them.
We particularly acknowledge the contribution of Professor Amanda Howe, RCGP vice chair, in ensuring that the voice of hardworking frontline GPs has been heard and is reflected in the report.