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The government has responded ‘positively’ to the majority of recommendations laid out in The Future of General Practice report, but it has rejected a series of measures intended to restore the GP-patient relationship.
The Future of General Practice report, written by the Health and Social Care Select Committee, was published last year. The report highlights the challenges being faced by general practice and provides clear recommendations to respond to them.
The government published its response to these recommendations this week, and while it has accepted or partially accepted the majority of recommendations, MPs are “disappointed” that a series of recommendations have been refused.
Patients must be able to access GP appointments when they need to
The government has acknowledged the crisis in general practice and says it shares the Committee’s view of the importance of ensuring that people can access GP appointments when they need them.
Ministers therefore agreed with the majority of recommendations, including:
- ensuring that trainee GPs are distributed across the country to support areas facing the greatest challenges in ensuring access to a GP
- simplifying how patients interact with the NHS with improved access
- increasing organisational support for GPs with a focus on back-office functions.
The government says that realising this broader vision may require “significant changes” to the way general practice operates and is contracted today, and it is committed to engaging with key players on this new structure.
“Over the course of the year, we aim to engage with the professions, patients, ICSs, and key stakeholders, on a broad range of themes including contracts, operating models, funding of GP IT and estates, to help inform how to shape general practice for the future,” the report states.
However, Ministers refused to accept a number of measures intended to restore the doctor-patient relationship.
Government says individual practices should decide how to meet the needs of patients
In The Future of General Practice report, MPs warned that care based on a doctor-patient relationship was essential for patient safety and patient experience, and accessing general practice should not be like phoning a call-centre or booking a cab driver never to be seen again.
MPs therefore made a recommendation for a national measure of continuity of care and a call for NHS England to champion the personal list model.
However, the government rejected this recommendation on the basis that individual practices should be able to decide the best way to meet the needs of patients.
The government rejected four more of the report’s recommendations, including:
- Urgent work needs to be done to stop a bidding war for the services of locums and establish requirements for a minimum fair share of administrative duties.
- NHS England should provide Primary Care Networks with additional funding to appoint a ‘continuity lead’ for at least one session per week, and additional admin staff funding to support the lead in the role.
- The Government should examine the possibility of limiting the list size of patients to, for example, 2,500 on a list, which would slowly reduce to a figure of around 1,850 over five years as more GPs are recruited as planned.
- NHS England should re-implement personal lists in the GP contract from 2030 onwards.
Doctor-patient relationships are “the heart of general practice”
Health and Social Care Committee Chair Steve Brine MP said that while he is pleased the government has accepted many of the recommendations, it is “disappointing” measures to restore the doctor-patient relationship have been ignored.
“We welcome the Government’s very positive response to many of our recommendations on general practice. It should help relieve the burden on GPs and improve access for patients. A number of issues that our inquiry examined have been addressed by the Government in its plan to recover access to primary care.
“What’s disappointing is that Ministers have rejected a series of measures intended to restore the doctor-patient relationship to the heart of general practice. The inquiry heard strong evidence to support continuity of care and we hoped to see NHS England championing the personal-list model as one way to help achieve that,” he said.