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The Royal College of GPs has published a new report setting out recommendations for the government to tackle the workforce and workload crisis in general practice after it found that one in four practices are at risk of closing.
The Fit for the Future: GP Pressures Report 2023 is based on a survey of more than 2,600 GPs and other practice team members from across the UK. It gives a snapshot of what frontline staff have faced during one of the most difficult winters experienced in the NHS, and what they think needs to happen to make general practice more sustainable.
It found GPs and their staff carried out 4.6 million (9%) more appointments in December 2022 and January 2023 compared to in 2019, however, the number of fully qualified full-time-equivalent GPs has dropped by 843 in the same period.
More than a quarter (26.7%) of respondents said they feared their practice would be forced to close, with almost 90% citing unmanageable workload pressures as a reason; while 65% said it was because of a GP partner leaving and 63% said it was because of a shortage of salaried GPs.
Primary care recovery plan
In the report, the Royal College says that the primary care recovery plan for England in 2023, promised by the government, must tackle the challenges facing primary care in both the short and long-term. Urgent measures should include:
- A commitment to a properly funded plan to enable general practice to respond to surges in demand as they occur.
- Investment in GP practices’ IT and telephone systems, and the support they need to implement upgrades.
- The urgent roll-out of new and improved, properly funded retention schemes that halt the decline in the GP workforce.
- A reduction in unnecessary box ticking requirements and unnecessary workload to free up GPs’ time for patient care.
- A new public education campaign designed by patients and healthcare professionals to advise patients when and how to self-manage illness and when to access general practice or other services.
Professor Kamila Hawthorne, Chair of the Royal College of GPs said: “It is hard to think of a more challenging time in general practice, too many GPs are now finding their position untenable and are feeling too stretched to guarantee patient safety. I’ve certainly heard of colleagues of mine becoming so stressed during their days of work that they’re developing chest pain and needing to be seen themselves. Many are also needing to take time off, due to stress at work. If you’re seeing 40 to 60 patients a day and making that number of clinical decisions, it is extremely stressful because each one of those clinical decisions is important.
“We are seeing more patients than we’ve ever seen before – and a greater proportion of our patients suffer with multiple chronic medical conditions – we are really busy and getting busier. Yet we have fewer doctors because GPs are leaving the profession due to the intolerable workload and workforce crisis that we’re under. So, we’re now 843 fewer full-time equivalent GPs since 2019, and the numbers are going down and down and down. That’s all extremely worrying.”
She added that there needs to be a sustained increase in funding for general practice, without the caveats and inflexibility that often come attached. They also need better IT systems to help patients book appointments more easily, and significant cuts to the bureaucracy that takes them away from patient care.