The college’s high-profile Put Patients First campaign has forced the issue of underinvestment to the top of the agenda for NHS leaders, politicians and the public.
‘We certainly got the message across. We had explicit recognition from Simon Stevens, who often talks about underinvestment in general practice over the past 10 years and quotes our figures,’ Dr Baker says.
‘The campaign has also won support from the public, with more than 330,000 signatures on our petition stating that general practice is underfunded.
‘And we secured a parliamentary debate on a motion supporting the need to boost general practice.’
But recent government figures have left an unclear picture as to whether that recognition of the problem is translating into action, and increased, recurring funding for general practice.
Spending review will be critical for GPs
It will not be until November this year that the results of the next government spending review will reveal how seriously ministers are taking the situation.
‘It would be hugely disappointing if there was no upturn in funding in England, because we really need to see an upswing in core funding for general practice, not just the one-off pledges,’ says Dr Baker.
She believes that it is not only the existing system of general practice that is endangered by the continuing lack of funding, but also the plans for the future of the health service set out in NHS England’s Five Year Forward View.
‘The Five Year Forward View is not going to be deliverable if this situation continues, so it’s in all of our interests to deliver on investment.
‘If, despite our campaign successes, the acute sector keeps receiving increasing levels of NHS funding, it’s going to be deeply worrying. But all we can do is raise the issue and try to hold NHS bodies and politicians to account.’
RCGP supportive of Five Year Forward View
The college is supportive of the Five Year Forward View, as ‘the only show in town to move the NHS forward to where it needs to be,’ says Dr Baker. But she is concerned that the multispecialty community provider (MCP) model is losing out to hospital-led primary and acute care systems (PACS) in terms of funding.
‘I am worried that the MCP models are not getting access to the funding available as easily as the PACS models. NHS England is used to working with the big finance departments of trusts and they already have those relationships, whereas the MCPs are new organisations and do not have that infrastructure.’
Nonetheless, Dr Baker sees a growing role for federations of GP practices in the development of NHS England’s new models of care.
‘It’s all about different parts of the healthcare system working together collaboratively, and GP federations are very much based on that approach. Federating gives practices a way of working together, and at scale, while retaining their relationships with local communities.’
The move to 21st century holistic care
Dr Baker says her keynote speech at the RCGP annual conference will focus on moving the NHS from 20th century to 21st century healthcare, away from hospital-based care to person-centred, holistic care in the community.
‘My belief is that strong general medicine is absolutely fundamental to the sustainability of the NHS.’
The vision for the NHS includes pharmacists and other clinicians joining community-based teams, led by GPs at the centre: ‘So if we can have other professionals working as part of the team in areas such as medicines management, that’s absolutely where we need to be going.’
Despite the funding crisis in general practice, Dr Baker is optimistic for the future of the profession. ‘I have never said this is the best time to be a GP, but I have said it’s the best time in a generation to become a GP.
‘Although it’s been declining for the past 10 years, I strongly believe that we will soon have an upswing in our fortunes and that’s why it’s the best time to become a GP.’