The mood was determined but hopeful among GP leaders as they gathered alongside MPs in the House of Commons yesterday for the launch of Pulse publisher Cogora’s workforce white paper.
The stark findings of the report – that a quarter of salaried GPs and locums are looking for a permanent role at the same time as practices are facing a shortfall in GP numbers – was the topic for discussion for around 60 guests at the event in Parliament, including GP leaders and 12 MPs.
These included GPs from the Rebuild General Practice campaign, who co-hosted the event with Cogora and Labour MP and working GP Dr Simon Opher.
It was also attended by the chairs of RCGP and the BMA’s GP Committee, Doctors Association UK (DAUK), the Institute of General Practice Management (IGPM) and several LMC leaders from around the country, many of whom significantly contributed to the white paper.
Pulse editor-in-chief Jaimie Kaffash, the report’s author, said: ‘GPs and practices are stuck in a vicious cycle. Rising GP unemployment alongside underfunded practices means that practices are unable to recruit the vital workforce to meet growing patient demand. Fewer GPs and more unemployed GPs is leading to unmanageable workloads for GPs and a severe increase in the risk to patient safety.
‘At the same time, GPs struggling to find work are stuck in a bottleneck – where demand for long term secure GP contracts is high while availability of these jobs is low. At the heart of the issue is core funding. The profession needs to see real-terms increase in funding for general practice, to expanding practices and encouraging training in the profession.’
Dr Opher said: ‘As a GP, I understand the workforce resourcing desperately needed within the profession. As the Government, we must place a priority focus on general practice as the backbone of our NHS. General practice is the first point of patient care and therefore we must ensure that this foundation is well equipped, resourced and funded to meet our patients’ needs. I am committed to continue working with our Government to ensure we can address the gaps within general practice to ensure the profession is fit for the future.’
Rebuild General Practice representative Dr Rachel Warrington, a former GP partner from Bristol who now works as a locum in North Wales, told event attendees that she was the perfect example of a GP lost to general practice in England.
On the white paper, she said: ‘These findings reflect our day-in and day-out experiences as GPs. We desperately need more GPs within the system to meet this increasing patient demand, but we simply do not have the funding or the space in our local practices for recruiting GPs. This means our workloads have reached unsustainable and unsafe thresholds.
‘As GPs, our unwavering commitment remains focused on patient safety, which is why we are sounding the alarm for immediate change. We are urging the government to allocate fair, real-time funding to general practice and prioritise the retention of GPs.’
Speaking to Pulse at the event, BMA GPC chair Dr Katie Bramall-Stainer welcomed the white paper publication and the support from Dr Opher, who is a long-time GP but newly-elected MP.
She said: ‘I’m really delighted to be here today. It is such an important publication.’
On the workforce and recruitment crisis, she added: ‘It all comes down to funding and it’s really important where that funding goes. Because we’ve seen infinite pots of pennies when we just need some simple pounds in practices. That is the key to unlock so many of our problems that will genuinely help fix the front door to the NHS. It will take time, because it has taken many years to get to this point, but general practice as the jewel in the crown of the NHS is absolutely retrievable and possible and that’s why I’m doing this job so we can get there again one day.’
Also at the event, DAUK GP spokesperson Dr Steve Taylor said of the white paper: ‘It is important as a publication because there are unemployed GPs and practices can’t afford to employ those GPs. Without the funding, there will be fewer doctors and it will take us in the wrong direction. And this is an emergency that needs to be dealt with within the next 12-18 months. It can’t wait for another 5-10 years. General practice gets such a small proportion of the NHS budget and there is flexibility to correct this.’
DAUK GP lead Dr Lizzie Toberty added: ‘I always say one of the key things is that it is absolutely possible to find that funding for general practice withing that timeframe. Because there is money there, it is in the ARRS, which is unevidenced and there is a growing feeling that it isn’t providing value for money. A better way would be to return that money into core funding to allow practices to flex their workforce to their local population. This isn’t a hopeless situation.’
Dr Rob Barnett, Liverpool LMC secretary, said the findings of the report are mirrored in the situation on the ground in Liverpool, with practices unable to recruit and new GPs unable to find positions.
‘It sounds a bit odd but that is the situation. And it is, as we’ve heard, because for practices the income and finances just don’t stack up.’
RCGP chair Professor Kamila Hawthorne said: ‘The troubling findings of this report sadly come as little surprise, and tally with what the College has heard from members.
‘Despite the frustration of both GPs and patients over long waiting times, practices are finding themselves unable to recruit the GPs they need, and GPs are reporting not being able to find appropriate work. This makes no sense. While there may be a range of reasons for this at practice-level, at the heart of this crisis is the chronic underfunding and poor workforce planning that have plagued general practice for decades. The efforts made to address this by freeing-up ARRS funding to employ GPs has been positive, but it is just a first step in resolving an endemic issue – and we agree with the recommendation in this report, that core funding that would allow practices to spend money in ways that best serve their local populations, should be increased.
‘As is often the case, this report also makes clear that patients living in deprived communities, and the practices working hard to care for them, are the hardest hit. On average, GPs in deprived areas are already responsible for 2,450 patients – over 300 more patients than GPs in more affluent areas – and this disparity will only intensify if employment difficulties persist and if our funding streams are not reviewed and more funding channelled to areas of greatest need.
‘We need to see the Government tackle the employment crisis in general practice head on. This not only means introducing measures to allow practices to recruit the GPs they need but placing a greater focus on retention, improving the situation for frontline GPs and supporting those who are working in areas of greater deprivation. It is simply unacceptable that practices are unable to recruit the GPs they need when so many patients are crying out for our services.’
You can find all the data and the methodology in the full report. Click here to download the full report
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Allowing disenfranchised GPs to take over the APMS contracts of profiteering Partner GPs who already have their own individual separate GMS practices and who additionally are running APMS contracts purely for financial gain in my opinion, particularly where those GPs have benefited from their previous LMC/ PCN CD or ICB contacts to further their contract ambitions would be a step in the right direction.
Aligning ARR roles to their rightful positions rather than replacing the former roles of GPs and to inappropriately further the profits of PCN CDs or PCNs would be further advance.
A focus on the increased difficulties of deprived and inner city area practices and the cessation of the ludicrous chart gazing of ICB & NHSE managers, many who have never seen the inside of a GP practice and who compare these disadvantaged practices to more affluent areas as above would be further progress.