Professor Martin Marshall: In my 30 years as a GP the job has never been so tough

RCGP chair Professor Martin Marshall sets out what the government needs to do to prevent a mass exodus of GPs, many of whom fear that the crisis in general practice is going to get worse rather than better.

RCGP chair Professor Martin Marshall (Photo: Grainge Photography)

I think being a GP is the most stimulating and professionally satisfying of careers, in particular because we are able to nurture relationships with our patients and use those relationships to increase our effectiveness as clinicians.

But in my thirty years of being a GP, the job has never been so tough. We simply don’t have the people, the resources, or the time to deliver the care our patients need, and the type of care that we want to deliver.

General practice, whilst widely acknowledged as the bedrock of the NHS, is a service in crisis and needs urgent support. What our members are telling us about working on the frontline is alarming.

Our service is significantly understaffed and underfunded, and GPs and our teams are working beyond their limits. This is impacting on the care and services we’re able to deliver to patients.

A new plan for GPs and patients

This is why the college has launched Fit for the Future: a new plan for GPs and their patients. We’ve put together a series of reasonable and necessary asks for the government that would make NHS GP services sustainable for the future.

We cannot wait any longer. Of the 1,262 GP and trainee respondents to our latest survey, 42% say they are likely to quit the profession in the next five years. Just over a third (34%) of these respondents plan to retire; but of those planning to leave for other reasons, 60% cited stress, working hours, and lack of job satisfaction as triggers for wanting to leave.

Our survey also found GPs and trainees not feeling as though they have enough time with patients and concerned about their patients’ safety as a result.

Over a third reported the premises they work in to be unfit for purpose, and IT booking systems falling short. Perhaps most stark: 80% of respondents think things are going to get worse rather than better.

Recruitment and retention

This lack of hope for the future is why the government must take heed of our calls for a new recruitment and retention strategy that goes beyond the target of 6,000 more GPs; a campaign to cut unnecessary workload and bureaucracy and free up GPs’ time to spend with patients; investment in IT and practice support to improve patients’ experience of accessing care; and to restore funding for general practice to 11% of total health spend, including £1 billion additional investment in GP premises.

Health and social care secretary Sajid Javid said last week that a plan was needed for general practice – the RCGP is saying that this must be a bold new plan to provide GPs and patients with the support that they need, and we’ve set it out for him in black and white.

We need the government to hear our warnings and commit to provide what is needed to make general practice Fit for the Future.

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