RCGP demands emergency rescue package for 'crisis-torn' general practice

A five-point rescue plan for general practice drawn up by the RCGP warns the profession is at 'breaking point' and urges the government to rebuild the workforce, cut bureaucracy, invest in infrastructure and ensure a strong voice for GPs in a changing NHS.

RCGP chair Professor Martin Marshall (Photo: Pete Hill)
RCGP chair Professor Martin Marshall (Photo: Pete Hill)

Day-to-day general practice was 'largely undoable' even before the COVID-19 pandemic, college chair Professor Martin Marshall has warned - and the pandemic has stretched the profession still further.

Pointing to data on surging workload and a GP workforce that is 4.5% smaller than it was in 2015, Professor Marshall warned: 'We simply do not have enough GPs to meet the needs of a growing and ageing population, with increasingly complex conditions, on top of managing the fallout and work backlog from the pandemic. If general practice collapses, the rest of the NHS will follow not far behind it.'

Professor Marshall called on the health secretary Sajid Javid to implement a five-point recovery plan to prevent GPs from burning out and to safeguard patients care.

The action plan for recovery calls for:

  • A ‘ramping up’ of efforts to deliver the 2019 Conservative manifesto target of 6,000 more full time equivalent (FTE) GPs in the next three years.
  • A system-wide programme to eradicate bureaucratic burdens and unnecessary workload by 2024, allowing GPs more time to care for patients and preventing GP burnout.
  • Improving the recruitment and integration of at least 26,000 other members of staff into the general practice workforce by 2024.
  • Developing general practice infrastructure that is fit for purpose by 2024 - allowing GPs to deliver care in a safe way from modern buildings and using reliable technology.
  • GPs to have a strong voice in integrated care systems (ICSs) to eliminate the waste associated with fragmented services, and in designing care for the communities they serve.

GP workforce

Calls for the government to press ahead with recruiting thousands of more doctors come after GPonline reported earlier this year that the number of fully-qualified FTE GPs per patient in England has dropped by 10% over the past five years as the workforce fell and patient numbers rose.

In March 2016 there were 51.4 fully-qualified FTE GPs per 100,000 patients registered with a GP practice in England, but by March 2021, this figure had slumped to just 46.3 per 100,000 patients.

Professor Marshall said: 'We need an expanded workforce with the appropriate support and premises if we are to improve access, reduce health inequalities, ensure patient safety, and give GPs more time to care for and build trusting relationships with their patients.'

Data from the RCGP/Oxford University Research and Surveillance Centre show GPs consultations have been rising since last summer - and have been above historic levels since the end of April. Consultations rates were 11% higher in June 2021 than they were in June 2019, and are at near record levels despite the summer historically being a period of lower demand.

Workload pressures

GPonline analysis of this data shows that practices delivered a third more clinical administrative work - including prescriptions and referral letters - and 8% more appointments in weeks 16-20 of 2021, compared with the same period in 2019.

The RCGP has argued that the workload pressures and burnout created by dramatic rises in day-to-day work are already impacting on GPs. Around three fifths of GPs say their mental health has deteriorated in the last year - and almost two thirds say they expect things to get worse over the next five year, according to the college.

Professor Marshall said: 'Even before the pandemic, millions of patients a week were seen in general practice and GPs were already under immense workload and workforce pressures. But these pressures are now unsustainable and must be urgently addressed as we move beyond the ‘emergency’ pandemic period and GPs deal with the aftermath of COVID-19 in their local communities.

'Despite the enormous strain under which GPs and their teams have been working, the latest independent GP patient survey reveals patients’ positive experiences. This is a testament to the efforts of GPs and their teams but the situation can’t continue for much longer without serious consequences.

'We are offering the new health secretary and the incoming leader of the NHS in England ready-made solutions to the problems that have beset general practice for more than a decade - our proposals will improve the care of patients for generations to come.'

'We now need urgent action and for those solutions to be implemented,' he added.

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