Fit for the Future: a new plan for GPs and their patients

General practice is the cornerstone of the NHS, helping around 50 million people in England every year, carrying out 370 million consultations last year. So, when GPs and their patients tell us that general practice is in crisis, we should all be concerned.


In 2019, we published the Fit for the Future: A vision for general practice report (PDF file, 1.1 MB), setting out the College’s vision for the future of the profession, in which it can continue delivering world class patient care, if given the right tools, skills and investment. 

Since then, the RCGP’s ‘Fit for the Future’ campaign has been calling on decision maker to commit to a bold new plan to provide GPs & their patients with the support they need.

Keep reading to find out more information about the campaign and the work we’ve been doing to represent our England-based members in Westminster.

What we're doing

Our recent survey of GPs paints a worrying picture of a service in crisis.

The Government must deliver a new support package for general practice and start to rebuild what we need to thrive in the future.

Find the latest updates on our campaign and influencing work here.

Read more about the work we do in Parliament to help secure change for general practice, and how you can get involved.

Find out more about our campaign work in Northern IrelandScotland and Wales.

The crisis in general practice

General practice is under immense strain which is resulting in workforce and workload challenges that are contributing to unsustainable levels of workload and difficulties for patients in accessing care. Years of under-investment in general practice and the chronic shortage of GPs and other members of the practice team means that without urgent action from politicians and NHS decision makers, the ability of general practice to meet patients’ needs is in jeopardy. Our members are worried that they don’t have the time to give patients the care they need. To tackle this, we need urgent action to grow the GP workforce, expand the general practice team and cut bureaucracy and unnecessary workload.

View key statistics and insights on the crisis in general practice
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Our plan for a better future

Since we launched Fit for the Future we've published a number of reports that highlight the challenges faced by general practice and recommendations to tackle these problems.

Fit for the Future: A new plan for general practice

We are calling on politicians and decision makers with responsibility for the NHS in England to urgently commit to a bold new plan to provide GPs and patients with the support that they need. 

In 2022, more than 4,600 GPs and GP trainees joined us in writing to the Health Secretary to demand that the government addresses the surging workload and workforce pressures facing GPs and their teams. These pressures are impacting the care they are able to deliver to patients and is leading to the potential mass exodus of nearly 19,000 GPs from the service in the next five years.

Download RCGP Fit for the Future - a new plan for GPs and their patients (PDF file, 647 KB)

Retaining GPs

Our 2022 survey of RCGP members found that 39% of the GP workforce across the UK are seriously considering leaving the profession within the next five years. 

Pressures will continue to intensify for those still in practice, creating a vicious cycle whereby increasing numbers of GPs continue to leave the workforce due to insurmountable pressures. Urgent action is needed to break this cycle, supporting today’s GPs to stay in practice, while we continue to train tomorrow’s GPs.

Download the full Retaining GPs report 2022 (PDF file, 790 KB)

Winter pressures

Winter 2022 was one of the most challenging yet for general practice. Without urgent action from politicians and NHS decision makers, next winter could be even worse. Our report paints a worrying picture of a service struggling under rising demands.

Download RCGP Fit for the Future: GP Pressures Report 2023 (PDF file, 707 KB)


Our report shows that the current state of premises and digital infrastructure is preventing GPs from delivering the care that patients need, with 4 in 10 general practice staff reporting their premises are not fit for purpose. The path to a brighter future for general practice requires upgraded, modern, and well-equipped infrastructure.

Download the full RCGP Infrastructure Report 2023 (PDF file, 1 MB)

International Medical Graduates Visas

Over 40% of all GP trainees are international medical graduates (IMGs) but many of them are finding that difficulties with obtaining a visa are causing them stress and anxiety. We have lobbied the UK Government to improve the visa rules for GP trainees from overseas.

Download  Fit for the Future: Opening the door to International GPs 2023  (PDF file, 650 KB)

Campaign progress

Retaining GPs

  • Following our call for a review of retention schemes in our 2022 report on retention, NHSE launched an internal review which is underway.
  • The March 2023 Budget largely addressed the call for pension reform which we made in our 2022 report on retention.

International Medical Graduate Visas

  • In May 2022, we wrote to the Home Secretary about this and shortly after, Vice Chair Margaret Ikpoh gave hard-hitting evidence to MPs on the Health Select Committee on this issue.
  • In October 2022, RCGP Former Chair Martin Marshall and Vice Chair Margaret Ikpoh wrote again to the UK Home Secretary, signed jointly with 4,367 GPs to put further pressure on the government to take action. We also shared a report with the Home Secretary, which contained testimonies of GP trainees and employers about how this issue is impacting on their lives and careers.
  • In November 2022, Matt Warman MP held a debate in Parliament on the issue, citing our report and recommendations.
  • In June 2023 we heard confirmation that the Government will amend immigration rules for IMG GPs arriving for Autumn 2023, granting them a four-month extension following CCT.

The RCGP will continue to work to ensure that GP trainee IMGs are supported throughout their career.


  • The Government published a Bureaucracy Busting Concordat which adopted our calls for a review into how the bureaucracy, red tape and unnecessary workload currently faced by GPs can be reduced.
  • The Government announced a review of the Quality and Outcomes Framework (QOF) as part of the recovery plan.

Delivery Plan for Recovering Access to Primary Care

While the Delivery Plan for Recovering Access to Primary Care left significant issues unaddressed, the plan featured a number of our policy asks. These include:

  • Further flexibility of funding in relation to the Additional Roles Reimbursement Scheme (ARRS) and the Impact and Investment Fund (IIF)
  • Investment in digital telephony
  • Investment in change management support
  • Investment in the expansion of care navigators
  • Adoption of agreements to improve interface between primary and secondary care and prevent re-referrals coming back to general practice.

Get involved

2024 General Election guide

As the front door of the NHS, general practice deserves to be high on the political agenda. To safeguard the future of general practice, the voice of GPs and their patients must be heard during this election.

Read our guide to the 2024 General Election
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Write to your MP

Write to your MP, asking them to encourage the government to address the crisis in general practice as a matter of urgency. Use the options below to send an email to your MP. There’s a template you can use, but personal stories go a long way in highlighting just how serious this crisis is.

Working, retired and training GPs

Members of the public