As Wes Streeting’s review kicks off, there is growing evidence on all sides that Labour’s promise to “bring back the family doctor” is headed for failure unless new resources are injected into GP practices.
The BMA is balloting GPs on industrial action to challenge the disastrous below-inflation 1.9% uplift in practice funding for 2024/25, as more GPs throw in the towel and hand back their contracts because of financial pressures.
The most recent closure announcement has been East Barnwell Health Centre – serving 8,000 people in the most deprived area of Cambridge, which has been left “financially unviable” by spiralling costs while funding has fallen further behind.
Costs include service charge rises of 400% in nine years levied by NHS Property Services (NPS). Dr Rachel Harmer told the BBC there had been no explanation of the soaring cost:
“Supposedly these are market forces, but I think any layperson would be surprised that one organisation with NHS in its name is effectively making it impossible for another NHS service to be operational.”
The Forest Practice in Hyson Green in Nottingham is another example of GP partners deciding to serve notice on their contract: the practice will close at the end of October with its patient list dispersed to nearby practices.
But it’s not the only one in the area facing problems, and Nottinghamshire LMC chief executive Michael Wright told GP online magazine Pulse 12 other surgeries could follow within the next three years, according to their survey of local GPs.
The LMC’s survey also found 57 practices (79%) have ‘reduced or stopped entirely’ their use of locum GPs due to ‘insufficient funding’.
As the problems and pressures mount in what is supposed to be a priority area for the new Labour government to expand, the Doctors’ Association UK has written to Lord Darzi summing up the growing crisis in general practice into twelve telling points.
The letter concludes:
“Supporting general practice now, will in turn reduce the burden and cost on secondary care in the long run, as well as being an essential part of helping people feel well again.
“However we really cannot continue to run on fumes.
We need a commitment from NHSE and the government to significantly uplift core funding and continue to do so in line with inflation.”
The 12 key points:
- There are 1,790 fewer full-time equivalent GPs working in the NHS since September 2015.
- A single full-time GP is now responsible for an average of 2,292 patients. This is 354 more than in September 2015.
- Despite this, GP practices are offering record numbers of appointments for their patients.
- More than 90 percent of a patient’s direct experience of the NHS is through primary care and their GP practices
- Despite growing demands for GP appointments, 6 out of 10 job-seeking GPs have struggled to find a vacancy to apply for over the past year
- A recent BMA survey showed that 84 percent of locum GPs in England cannot find work, and 33 percent of GPs have already made definite plans to change work or career paths. This makes no sense when we have patients desperate for appointments but no money for practices to pay for these doctors
- 64 percent of GP practices report concerns over short and long-term viability. 57 percent have experienced cashflow issues in the last 12 months. And 54 percent report that these cashflow challenges adversely affect their day to day performance
- Over 1,000 GP practices have closed since 2015. This amounts to an average of one practice closure every three days.
- GP core funding is just £107.57 per patient per year.
- Schemes aimed at reducing GP appointments such as Pharmacy first, the Additional Roles and Reimbursements Scheme actually cost more money to run.
- US Data shows that care provided by non-physicians providers is ultimately more expensive and leads to higher rates of emergency department use
- Independent research from Carnall Farrar shows that for every £1 invested in community or primary care, there is up to a £14 return back into the local economy. All these factors have impacted the workforce morale and greatly compromised the standard and continuity of care.
DA UK is inviting GPs to add their signatures to the letter.
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