King’s Fund highlights causes behind “crisis” in general practice

GP CONSULTATIONS have increased by 15 per cent over the past five years which is three times the growth in GP numbers, according to new research on the extent of the "crisis" facing general practice.

The report by the Kings Fund – Understanding pressures in general practice – found a 13 per cent growth in face-to-face consultations and a 63 per cent growth in telephone consultations which is "contributing to stressful and highly pressurised working days for GPs".

The biggest increase in consultations was among patients over 85 (up 28 per cent), who are more likely to have more than one chronic condition. Using other members of the primary care team to triage and manage minor illness may ease demand for the practice overall but it also means that GPs tend to see the most complex cases requiring more than a 10-minute appointment.

The report also concluded that the move to transfer patient care closer to home has not been coupled with the equivalent transfer of resources to primary care, again increasing the pressure on GPs.

Over 30 million patient contacts from 177 practices where analysed in the research along with trends in GP recruitment and retention.

The report found that five years after qualifying, only 1 in 10 new GP trainees plan to be working full-time seeing patients in general practice. GPs are also retiring earlier and in greater numbers: between 2009 and 2014, 46 per cent of GPs leaving the profession were under 50, and between 2005 and 2014 the proportion of GPs aged between 55 and 64 leaving doubled.

The authors conclude that general practice is at risk of "falling apart" unless significant additional investment is accompanied by new ways of working that build on current good practice.

Beccy Baird, Fellow at The King’s Fund and lead author of the report, said: "Investment alone won’t help the crisis in general practice. To avoid the service falling apart, practical support to do things differently is crucial and must be underpinned by an ongoing understanding of what is driving demand and activity. Only then will working in general practice be an attractive proposition and ensure the service remains at the heart of the NHS."

Dr Maureen Baker, Chair of the RCGP, commented: "NHS England’s recent GP Forward View provided long overdue recognition of the essential role GPs and our teams play in keeping the NHS sustainable and safe for patients. But it was also an acknowledgement of the devastating impact of a decade of chronic underfunding for general practice.

"It is vital that the pledges of increased funding and support for general practice set out in the GP Forward View are put in place as quickly as possible. If implemented effectively they will go a long way towards alleviating the pressures highlighted by today’s report."