GPC England vision sets goal of one GP per 1,000 patients by 2050

Practices should have a list size of up to 1,000 patients per GP to ‘ensure safety’, the BMA’s GP committee has said.

This forms part of a ‘vision’ document, presented by GPC England at a London roadshow yesterday evening, containing its asks for the new Government.

As it stands, a single full-time GP is now responsible for an average of 2,292 patients, according to NHS England data.

But GPC chair Dr Katie Bramall-Stainer said that practices ‘must be bold’ and ‘aim for a gold standard’ of one GP per 1,000 patients by 2050, because they ‘need a safe GP-to-patient list-size ratio’ to ensure a ‘manageable workload and patient safety’.

Earlier this year, the GPC said that a ‘recommended’ number of registered patients per GP should be included in the next GP contract.

Other demands in the vision document include reinstating the New to Partnership Programme; a 1% annual incremental rise in the proportion of NHS funding allocated to general practice; incentivising continuity of care; and including practice nurses in the Additional Roles Reimbursement Scheme (ARRS).

Dr Bramall-Stainer said: ‘Practices need a safe GP to patient list size ratio to ensure a manageable workload and patient safety.

‘Our lists sizes have grown far beyond safe levels in England, and our safe working guidance is based on models across Europe that recommend we deliver no more than 25 consultations a day whilst also safely managing other responsibilities: pathology results, patient tasks, home visits, palliative care, clinical training and supervision associated clinical governance, non-NHS work, local authority work, DVLA, safeguarding. the list goes on.

‘No wonder we’re logging on late into the evening or in the early hours to deliver our sessions of work and appointments that don’t get counted.’

She also told the audience she had met with health secretary Wes Streeting yesterday and suggested that he seemed ‘seriously concerned’ about potential collective action by GPs, which the GPC is planning to start on 1 August depending on the results of a ballot of partners.

The ballot, carried out by software company Civica, closes on Monday 29 July and asks partners if they are ‘prepared to undertake one or more examples of collective action’ as outlined in the BMA campaign to Protect Your Patients, Protect Your Practice.

Dr Bramall-Stainer said: ‘It was a really positive introductory meeting. What was clear to me was how seriously concerned the secretary of state was with what we are potentially looking at ahead of us in the next few weeks.

‘Of course, it all depends on the vote, it all depends on the ballot, and that’s out of the BMA’s hands, that’s sitting with Civica.

‘We don’t know what those results are going to look like. But if we’re going to have the leverage to be able to try and get some traction on some solutions, we need as many GPs to vote as possible.

‘So that’s my message to you. But the message from the secretary of state was that he wants to rebuild trust. And I that was music to my ears. But these are wonderful words, but we’re going to need to see tangible actions.’

On reinstating the New to Partnership Programme, Dr Bramall-Stainer said that ARRS money should be reallocated to the programme to make sure practices retain ‘roles that are absolutely essential’.

She said: ‘We want to reinstate the highly successful New to GP Partnership Programme, we must secure these roles into practices. So we want to potentially use additional roles funding, but this needs to be in practices around continuity of care, locked into the patient list.

‘We can’t have GPs floating, not feeling like they belong – they need to belong, they need to understand their populations, and feel owned by their practice family.

‘We must secure these roles into general practice because otherwise this is literally a multi billion pound brain drain of the past decade of homegrown GPs.

‘Otherwise, we are becoming an export scheme to Canada or name any other nation. Monies can potentially be reallocated to that scheme from historic ARRS underspend, from reusing and reallocating all those infinite little transformation pots, or using existing additional roles reimbursement scheme monies to make sure we’re going from roles that are nice to have to roles that are absolutely essential.’

The inclusion of GPs in ARRS had been a ‘red line’ for GPCE in 2024/25 contract negotiations but NHS England declined the request on the basis that GPs are core, rather than additional workforce in practices.

The Labour Government has pledged it will provide incentives for GPs to boost continuity of care but has not yet set out any detail on the proposals.