Spring Budget must provide investment to end crisis in general practice, says College Chair

Professor Kamila Hawthorne, Chair of the Royal College of GPs, has written to Chancellor Jeremy Hunt asking for the Spring Budget to provide urgent investment in GP recruitment and retention, and to change rules so that funding is flexible enough for GPs to adapt to local demand.

Last year, the Government announced that it will publish a primary care recovery plan for England in 2023, in addition to the long-awaited NHS long term workforce plan. The Royal College recently published Fit for the Future: GP pressures 2023, which outlined the urgent measures needed to tackle the challenges facing primary care in both the short and long-term.

The Rt Hon Jeremy Hunt MP
Chancellor of the Exchequer
1 Horse Guards Road

1 March 2023

Dear Jeremy,

As you know, general practice is dealing with unprecedented levels of patient demand. General practices in England carried out 4.6 million (9%) more appointments in Dec 2022 and Jan 2023 than the same months the winter before the pandemic. Whilst the number of appointments continue to grow, the number of FTE fully qualified GPs has dropped by 2,077 (7%) since 2015.

This demand is inevitably having an impact on patient care, with 65% of GPs in our recent tracker survey saying that patient safety is being compromised because they don't have enough time to spend in consultation with patients.

As you prepare for your Spring Budget, I want to highlight some of the most important recommendations set out in the report published while you were Chair of the Health and Social Care Select Committee. This set out a bold vision for the future of general practice, including an expanded workforce, empowered to deliver continuity of care for patients, while improving access. Delivering this will be critical to the recovery of general practice and building a bright future for our profession and patient care.

In the Autumn Statement you said that the Government will publish a Primary Care Recovery Plan. It is vital that the scale of this plan and the NHS workforce plan matches the challenges faced in general practice. This will only be possible with support from the Treasury.

The recent rise in the number of people training to become GPs has been welcome but as made clear in the Select Committee report, the Government is not on track to meet their manifesto commitment to recruit an extra 6,000 GPs. We therefore welcome the suggestion in the press that the Government is planning to double the number of medical students.

Alongside this we will need to significantly expand the capacity for student placements in general practice, and to double the number of training places for these new students once they graduate. This will need both the additional staff to train them and significant investment in infrastructure. In a recent RCGP survey, 73% of general practice staff said their practices had little or no capacity to increase training places without additional funding.

While training more GPs is important, we also need to do much more to retain the staff we have. Our 2022 report on GP retention included survey results showing that 42% of GPs are planning to quit the profession in the next five years. To tackle this, funding is urgently needed so that GPs in every ICS can access either locally tailored retention initiatives or the national retention scheme for those at highest risk of leaving the profession. It is also important that you act once and for all to finally end the pension trap which is driving too many doctors to retire early or cut down on their work.

Alongside this, it is essential that existing and new funding streams are flexible and simple for general practice to access and use effectively, tailored to their locality needs. This requires reform of existing funding streams such as the Additional Roles Reimbursement Scheme, the Impact and Investment Fund, and a wholescale review of the requirements of the Quality Outcomes Framework.

I understand that you must be busy preparing for the Spring Budget, but I do hope that you will agree to meet with me to discuss these issues as soon as possible.

I look forward to meeting you again.

Yours sincerely,

Professor Kamila Hawthorne
Chair of RCGP Council

Further information

RCGP Press office: 020 3188 7633

Notes to editor

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.