Challenging Welsh Government assumptions on general practice at scale

Dr Rowena Christmas, Chair RCGP Cymru Wales, has expressed concern at the assumptions behind a Welsh Government statement.

The Senedd will be debating an opposition motion on GP practices and funding on Wednesday 15 May. This is very welcome, as are the constructive ideas put forward by all parties in their motions and amendments.

However, Dr Christmas explained her concern over a specific aspect of the Welsh Government amendment which states ‘the reduction in overall practice numbers reflects a trend towards larger practices as GPs seek to reduce costs and maximise resources for patient-facing activity’.

Dr Christmas said:

“While there may be examples of this model in Wales, I  certainly do not recognise the description of it as a ‘trend’. What has been more apparent is that smaller practices, which tend to be more financially vulnerable, have been lost.  

"Where the affected patients have been moved to other practices this has not typically been a matter of maximising resources but rather necessity. I would encourage evaluation of the impact of this on patients. I am sceptical that this scenario has been of benefit to patients and fear that practices with larger patient lists are struggling with greater demand but little uplift in resource. 

"Furthermore, there is a very practical obstacle to the idea of a larger practice by design model; there simply is not the primary care estate to properly accommodate such services in most settings. 

"I believe there are examples of larger practice by design elsewhere and I am not opposed to the model in principle. However, we do need to differentiate between a strategy to deliver better patient care at scale and necessity driven transfer of patient lists to practices due to a sustainability crisis in general practice.”

Further information

Nicolas Webb
Policy and Public Affairs Manager
Tel: 020 3188 7767

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.