The GP funding package launched in 2016 is suffering from ‘fundamental' problems and needs an extra £2.5bn a year to have an impact that will be felt by doctors on the frontline, the RCGP said.
The additional funding would take total annual spending on general practice to £14.5bn a year - 11% of the NHS budget. Under current plans, the college warned, the proportion of NHS funding spent on general practice could fall to 8.9% by 2020/21, lower than it was before the GPFV was launched.
The RCGP’s second annual assessment of the GPFV highlighted that the five-year plan was struggling to deliver the 5,000 extra full-time equivalent GPs by 2020 promised by former health secretary Jeremy Hunt, with the workforce down by 1,000 since the target was set.
‘There were not enough doctors working in general practice when the GP Forward View was published,' the RCGP report warned. 'Now, there are even fewer. This is a fundamental problem and while it persists many of the other commitments in the GP Forward View cannot achieve the impact they were designed to deliver.
‘Without enough GPs, excessive workload remains a major problem, exacerbating the pressures that are causing doctors to leave the profession.’
Although a £2.4bn increase in GP funding by 2020/21 promised in the GPFV is on track to be delivered, a survey by the college of 1,216 GPs found it was failing to have an impact on the frontline. The college warned that general practice had become a more challenging place to work since the 2016 plans were set out.
RCGP chair Professor Helen Stokes-Lampard said: ‘[The GPFV] needs an urgent overhaul to address the pledges that are not progressing fast enough, particularly around retaining our existing workforce and reducing our workload; and to recognise the changing landscape of NHS funding, which now includes a promise of £20bn extra a year by 2023.
‘General practice is the lifeblood of the NHS. GPs and our teams make the vast majority of NHS patient contacts for little over 9% of the overall budget, and in doing so we alleviate pressures in hospitals where care is costlier.
‘The new health and social care secretary recently identified workforce and prevention as his top priorities. If he is serious about tackling the workforce crisis and keeping patients out of hospital, it is essential that the government invests properly in general practice.’
The college acknowledged progress under the GPFV, including the employment of a record number of trainee GPs in 2018, plans for state-backed medical indemnity and expansion of practice teams.
But Professor Stokes-Lampard added: ‘GPs and our teams across the country are struggling – and that makes innovation almost impossible. Our workload is constantly escalating, both in volume and complexity, and we are constantly firefighting, trying to keep up with demand, without enough resources to do so.
‘It is now time for us to go above and beyond the original GP Forward View. The vital importance of general practice must be recognised as decision-makers draw up plans as to how to spend the new money that the prime minister has promised for the NHS. We believe that at least £14.5bn is necessary – an extra £2.5bn a year on top of what has been promised in the GP Forward View.
‘Only then will we be able to continue to guarantee the safe care our patients need and deserve, close to home where they want it most, away from hospitals where care is more expensive. Investing in general practice truly is investing in patient care right across the health service.’
An NHS England spokesperson said: 'GPs play a vital role, which is why the NHS is on track to increase primary care spending by an extra £2.4bn by 2020. Rather than individual lobbying groups plucking implausible figures from the air, the NHS is now carefully developing a long-term plan for affordable and phased improvements over the coming decade.'
The NHS is consulting with groups such as the RCGP about what further improvements can be delivered as part of their long-term plan.