London primary care needs £1bn funding boost, LMCs warn

Primary care investment in London needs to double to halt the erosion of services and to ensure patient safety in the capital, Londonwide LMCs has warned.

Dr Michelle Drage: London primary care investment must double
Dr Michelle Drage: London primary care investment must double

The call for the huge increase in investment came from Londonwide LMCs chief executive Dr Michelle Drage, who warned that the capital's 6,000 GPs are experiencing 'total overload'.

The total NHS budget for London in 2013/14 was around £15bn. Doubling the 8% share Londonwide LMCs says that primary care currently receives would increase GP funding from £1.2bn to £2.4bn a year.

A Londonwide LMCs policy blueprint published this month, Securing the Future of General Practice in London, calls for GPs to be freed from bureaucracy to be able to spend longer with patients, many of whom have co-morbidities.

Investment in primary care and general practice has been ‘reduced year on year over almost two decades’, it states.

The extra funding could be used to support plans in the Londonwide LMCs policy paper for multidisciplinary primary care teams ‘focused on GP practices or established collaborative models structured according to local need’. The report also calls for more general practice nurses and a ‘move away from models that are aimed at developing an alternative provider market’.

‘We believe that effective change in London will only be achieved by underpinning the role of general practice and strengthening community-based services to support the millions of patient consultations that take place each day and each week in the capital,’ it reads.

‘Strong general practice is both the root of and route to better care for Londoners and requires a paradigm shift in the way services are commissioned and transformed.’

Dr Drage said that secondary care providers dominate the commissioning process and primary care only gets whatever money is left over. This is why general practice only receives 8% of the budget in London, she believes.

‘The commissioning process is the wrong way round,’ she told GP. ‘We were barely managing on 10%, we are crumbling on 8%, we are not able to meet everyone’s needs and the increased demand.

‘It requires doubling or trebling the amount of resource [going to primary care].’

On the possibility of increased funding for primary care, she said: ‘It is perfectly possible, there is nothing structural about this.

‘You have to recognise that primary care is the solution.'

GP access will worsen if primary care does not receive more investment, she warned. ‘The service will continue to decline. GPs will continue to not want to work in London.’

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