2017 was certainly a busy one for the college – and we don’t expect things to let up in 2018, or even 2019. We are on a mission to ensure that NHS England’s GP Forward View – with its pledges including £2.4bn extra a year for our profession and 5,000 more GPs by 2020 - is delivered in full in England, and for equivalent promises to be made and delivered in Scotland, Wales and Northern Ireland.
Our first annual assessment of the GP Forward View, published last July, concluded that while there has been progress in the plan’s delivery, it isn’t happening fast enough. We are certainly not looking at the GP Forward View through rose-tinted glasses and we will continue to hold the government and NHS England to account on its delivery in 2018.
We must not overlook the good. In 2017, in England we saw the NHS GP health service introduced, general practice received an increased share of the NHS budget, and in October – at our annual conference in Liverpool – health secretary Jeremy Hunt announced plans for a state-backed indemnity scheme for GPs.
There were also success stories in the devolved nations, including health and social care receiving a cash boost in Northern Ireland, and some positive announcements around workforce in Wales and Scotland.
However, it is impossible not to be concerned by some revelations from last year. In November, figures from NHS Digital revealed that our workforce in England has actually declined by over 600 full-time equivalent GPs in the six months between March to September.
Nobody can make 5,000 more GPs appear by magic, but we need those doctors, and the college had hoped that by this stage we would be seeing an increase in numbers, not a decrease.
Clearly a lot needs to be done in 2018. This year we will begin to welcome more overseas doctors to our profession as part of international recruitment efforts. But we also need more initiatives to retain doctors in our workforce across the UK.
It is fantastic that more foundation doctors than ever before are choosing to enter GP specialty training, but from that point it takes a minimum of three years before those doctors can practise independently as a GP. We don’t have that long.
Nevertheless, the college will continue our campaign for more funding for longer and better-quality GP placements as part of medical training – one of the recommendations that came out of Destination GP, our recent report exploring medical students’ career aspirations.
The report found that 76% of medical students had heard negative comments about general practice by their last year at university. When these archaic perceptions of our professions prevail, the future of our profession is in jeopardy.
We know that more, and earlier exposure to high quality general practice during medical training encourages students to choose general practice - and that initiatives that promote our profession, such as GP Socs can work wonders to counter these negative stereotypes.
Please support our calls for more funding for high-quality general practice placements by writing to your MP using our online tool – you can adapt it to write about your own experiences, if you feel it appropriate.
Another key issue the college will be addressing in 2018 is workload; something we know has risen by at least 16% over the last seven years. Increasing the workforce is one solution and there are systematic changes that need to happen, but also we need to educate our patients more about appropriate alternatives to making GP appointments.
Last week we launched ‘3 before GP’ – our new mantra to encourage patients to ask themselves whether they can self-care, use NHS Choices or a similar reputable UK website for health information, or seek advice from a pharmacist, before seeing a GP for an acute onset illness. While the message is particularly pronounced over winter, the principles remain all year round.
Another of my priorities for the coming year is to continue my quest to restore joy to the consultation – one of my manifesto pledges when I became Chair of the RCGP. I touched on this during my annual conference speech last year when I introduced delegates to ‘Enid’, an elderly widow who, whilst having a number of ongoing health issues, is fundamentally lonely.
The NHS is 70 this year and in my opinion the best gift for all healthcare professionals will be to have the time, resources and capacity to deliver ‘Enid-shaped care’ to Enid, and person-centred care to every one of our patients that needs it. That’s what gives me the greatest joy as a GP.
I’m incredibly proud of our NHS. It’s had a hard time of late, but it remains the envy of the world and as a GP and chair of the RCGP I will do everything I can to make sure it flourishes once more. GPs are the foundation of our remarkable health service, and without them, it would look very different.
My very best wishes for the new year.
- Professor Stokes-Lampard is chair of the RCGP