With the Comprehensive Spending Review coming up, General Practice funding must take centre stage

College Chair Kamila Hawthorne has written an op-ed, a version of which has appeared in inews, detailing the College’s policy calls on the Chancellor’s spending Review.

It is no secret that general practice is under immense pressure. GPs and our teams are facing mounting patient need for our care and services (367m appointments were made in general practice last year, 20m more than the year before) yet, although GP numbers are rising slowly, we only have a couple of hundred more than we did in 2019.

Tomorrow’s Spending Review is the Government’s opportunity to tackle the crisis head on; to address longstanding failures in healthcare workforce planning and provide GPs with the support needed to ensure patients get a quality service.

The Darzi review made clear that the NHS has major problems that will take long-term reform and investment to fix - but also that general practice had the best ‘financial discipline’ of any sector in the NHS. Lord Darzi’s right, general practice is the foundation of the health service, and when it is properly resourced, it alleviates pressure across the NHS by delivering care close to home, where patients want it, where it is more cost-effective and can both prevent sickness and illness getting worse.

Yet less than 10% of the NHS commissioning spend in England is spent on primary care and core funding for general practice has fallen as a share of NHS funding. For too long spending reviews have treated general practice as if we were the black sheep of the NHS rather than its bedrock. This has to change.

Funding for general practice needs to increase in the Spending Review, and this must be maintained; a one-off influx of cash won't achieve enough.

This is why we're calling for a Primary Care Investment Standard, ensuring that both central government and ICBs [regional funding and decision-making bodies within the NHS] increase their spending on general practice and primary care each year. We also need to see investment in a national GP retention scheme, to help keep GPs at all stages of their careers in the profession longer.

One of the Government’s three ‘key shifts’ to transform healthcare is to move more care from hospitals to the community. This is something the RCGP supports, but only if sufficient resources follow. If they don’t, practices will continue to close, GPs will continue to leave the workforce, and patients will continue to wait too long for appointments.

The Government has made some encouraging first steps to demonstrate it values general practice and the work GPs and our teams do day in day out to care for patients, but we’re a long way off our service being on a solid footing.

A recent College survey found that over a third (34%) of GPs say that their practice building is not fit for purpose, and 57% of GPs said their practice requires additional works to improve or upgrade their premises in order to meet the needs of their patients. As such, we're also calling for additional ringfenced funding - at least £2 billion - to address the shortcomings in our premises. Without it, we simply won't have the space to accommodate more patients or to train the numbers of GPs we need.

The Spending Review is an opportunity for the Government to offer a serious and long-term financial commitment to the future of the NHS; by specifically guaranteeing funding for general practice. The success of the forthcoming 10-Year Health Plan and subsequent review of the Long-term Workforce Plan – and, most importantly, patient satisfaction with general practice and the wider NHS – will depend on it.

If we keep kicking the can down the road we can't expect better results. Without a commitment to sustained investment in our service, our workforce and our infrastructure, the problems plaguing the profession will persist.

Further information

RCGP press office: 0203 188 7659
press@rcgp.org.uk

Notes to editors

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.