Source · Select Committees · Health and Social Care Committee
Recommendation 1
1
Accepted
Paragraph: 32
General practice in crisis due to poor patient access and safety risks, unacknowledged by government.
Conclusion
The first step to solving a problem is to acknowledge it and we believe that general practice is in crisis. It is clear from the latest GP Patient survey results that despite the best efforts of GPs, the elastic has snapped after many years of pressure. Patients are facing unacceptably poor access to, and experiences of, general practice and patient safety is at risk from unsustainable pressures. Patient access is at the heart of NHS general practice and we are very concerned about this decline in standards. Given their reluctance to acknowledge the crisis in general practice we are not convinced that the Government or NHS England are prepared to address the problems in the service with sufficient urgency. The Government’s Plan for Patients places a welcome emphasis on improving access to general practice but the measures set out so far will not be sufficient to make a meaningful difference to patient access and do not deal sufficiently with how to improve outcomes.
Government Response Summary
The government partially accepts, acknowledging access challenges but not a 'crisis'. It details ongoing efforts and specific actions from its Delivery Plan for Recovering Access to Primary Care, including a retargeted investment of over £1bn (up to £645m in community pharmacy, £240m for a new access approach), recruitment of over 29,000 primary care professionals since 2019, and measures to reduce GP bureaucracy.
Paragraph Reference:
32
Government Response
Accepted
HM Government
Accepted
Partially accept. The Department partially accepts this recommendation. We recognise that some people are facing challenges trying to access general practice services in a timely way, and general practice teams have been working immensely hard to meet increased demand for care. The Delivery Plan for Recovering Access to Primary Care, published on 9 May 2023, acknowledges the pressure that general practice is under and commits to making it easier and quicker for the public to get the help they need from primary care. The Plan includes measures to empower patients by investing in tools people can use to manage their own health better and expanding services offered in community pharmacy by: • Retargeting over £1bn including investing up to £645m, over 2 years into community pharmacy; implement a new ‘Modern General Practice Access’ approach to tackle the 8am rush, backed by retargeted funding of £240m, so patients will no longer be asked to ring back another day for a response. • Building capacity so practices can offer more appointments, from more staff, than ever before; and cut bureaucracy to give practice teams more time to focus on the clinical needs of their patients, including freeing up £246m in funding for networks and reducing workload by streamlining the Impact and Investment Fund and Quality and Outcomes Framework. We have also committed to expand the use of self-referral and direct access into a range of community and secondary services for patients where GP involvement is not clinically necessary to free up GP and other general practice time and appointments. Alongside these measures, NHS England will introduce a National General Practice Improvement Programme with three tiers of support to help general practice deliver change that is clinically led, data-driven, evidence-based and measurable. We have committed to provide an additional 50 million appointments which will depend on growing and diversifying the workforce in general practice. We are working with NHS England and Health Education England1 to explore what more can be done to grow the GP workforce. In particular, we have record numbers of doctors in GP training. The NHS Long Term Workforce Plan sets out how many doctors—including GPs—the NHS will need in future, and the actions that are required to increase workforce capacity in primary care. This includes increasing the number of GP training places from 4,000 to 6,000 by 2031/32 with the first 500 new places available from September 2025. The Plan builds on the actions already in train. General practice teams include a range of other health professionals who are able to respond to the needs of their patients, which is vital for improving access to General Practice services. As of 31 March 2023, over 29,000 additional primary care professionals have been recruited compared with a baseline of March 2019. We are supportive of enabling appropriately qualified doctors other than GPs to work in general practice as part of a multidisciplinary team to help increase practice capacity and improve care for patients. Local systems can use available flexibilities within the regulations to deliver care in a different way in line with local need and where general practice wants to take advantage of this. We have also made further changes to reduce unnecessary bureaucracy for GPs to free up time for appointments, including expanding the range of healthcare professionals who can sign fit notes, and publishing the Bureaucracy Busting Concordat, which consists of seven principles to reduce unnecessary burdens. We continue to work across Whitehall on this important agenda, seeking opportunities wherever possible to remove, reduce or streamline the requests on general practice.