Appearing before the first session of the new House of Commons health select committee, Mr Stevens warned that the clinical model of general practice would need to be reinvented to cope with demand, and admitted that the 5,000-GP recruitment target would be tough.
Mr Stevens said he ‘very much hope[s]’ the Conservatives' pre-election pledge to recruit 5,000 new GPs by the end of the current parliament can be met.
Earlier this month health secretary Jeremy Hunt was accused by Labour of 'evasiveness' after appearing to water down the 5,000 target from a minimum to a maximum number of new GPs.
|Read more from GPonline.com on seven-day NHS|
Mr Stevens said there were ‘real problems’ with fill rates for GP training schemes in parts of the country including the east Midlands, east and north east of England. Only eight in 10 places have been filled across the UK, and Health Education England (HEE) has launched a third round of recruitment for GP trainee posts - only the second time this extra round has ever taken place.
HEE, Mr Stevens told MPs, was working to meet its target for half of new doctors going into GP training. ‘A combination of the expanded number of training places and some recruitment and retention is what they are being tasked with ensuring gives us, the NHS, 5,000 more GPs by 2020. It could be more than 5,000 - frankly, we would welcome that. But 5,000 is going to be tough under the circumstances, anyway.’
There had been, he added, a ‘huge’ effort by the NHS, HEE, the RCGP and the GPC to help relieve pressures on GPs. These pressures were less noticed, but as substantial as pressures on hospitals, the NHS England chief executive told MPs.
New model of general practice
‘We are at a pivot point,' he added, ‘where we’ve actually got to do something in terms of reinventing the clinical model, the practice business model, the career model. Keeping all that is great about British general practice - list based, personal care with a population orientation - but nevertheless recognising that actually the pressures and lifestyle choices that people want to make means that just having all the work people can throw at you is not a sustainable model for general practice anymore.'
Mr Stevens told the committee that not every practice would be expected to open on weekends under plans to roll out a seven-day NHS service for every patient in England.
The NHS chief said there was evidence from Challenge Fund pilots that expanding weekend GP services can reduce A&E attendances. Demand for non-urgent appointments is greater on weeknights than on Saturdays with even less on Sundays, he said.
Routine GP appointments
‘I dont think it is the expectation that every practice will be offering routine appointments seven days a week.’
Groups of practices will, he explained, be able to cover extended hours on a rota basis. ‘For the weekend offer for routine primary care, we have got to shape that based on where there is need and where there is uptake.’
‘So if there is not need or uptake for particular modes or times, then obviously that’s not going to be where we are going to put all of our eggs.’