The RCGP has warned that as many as 19,000 GPs and trainees could quit general practice within five years unless the government takes rapid action to ease intense pressure that has left doctors and patients increasingly at risk.
But the college says that despite the depth of the crisis facing the profession, there are measures the government could take to begin to turn it around.
In its report 'Fit for the Future: a new plan for GPs and their patients', the college sets out measures on areas including workforce, funding, bureaucracy and infrastructure. Read through a summary of the measures or the RCGP proposals in full below.
What are the key RCGP proposals?
The RCGP says general practice needs an 11% share of the overall NHS budget. In 2018 it said the share of funding going to the profession was on track to drop below 9%. The college says this funding could deliver:
- a nationally ringfenced retention fund worth £150m a year,
- additional funding of at least £100m per year to develop primary care networks,
- funding to help practices in deprived, underdoctored areas recruit GPs as part of an overhaul of the 'Carr-Hill formula' that underpins the current GP contract,
- £1bn to support development of GP premises.
The government has admitted it is not on track to deliver the 6,000 extra GPs its 2019 general election manifesto promised by 2024. The college is calling for a new plan to go well beyond this figure - and to exceed the promised 26,000 staff to support primary care through the additional roles reimbursement scheme (ARRS). It wants:
- more flexibility around ARRS funding to allow practices to let practices bring in the staff they need, including nurses,
- 10% expansion of GP training places year-on-year, along with more trainers and premises expansion to support this,
- measures to help international medical graduates who complete UK GP training to apply for long-term visas, bringing their situation in line with doctors who complete five-year training in other specialties and are then automatically entitled to indefinite leave to remain.
The college has been calling for a reduction in bureaucracy and a move away from QOF targets for some years. Its Fit for the Future blueprint demands:
- changes to the way general practice looks after the most vulnerable patients, moving from QOF to 'a system that encourages GPs to focus on those who need care most and cuts out the red tape and box ticking',
- eradication of unnecessary bureaucracy to free up staff to focus on patient care, in part through 'a review of contractual requirements and improving co-ordination between primary and secondary care'.
Underinvestment in premises is a long-standing problem for general practice and a shortage of space has been exposed by the need to find room for thousands of staff joining primary care through the ARRS. With 74% of respondents to polling by the college warning they do not have room for extra staff, the RCGP is calling for:
- £1bn additional investment in GP premises,
- improved IT systems to 'make it easier for medical staff to share patient records and information about what they need to improve relationship-based care'.