The “crisis” within England’s GP service has been condemned in a damning new report , saying getting an appointment should not be like “phoning a call centre or booking an Uber driver who you will never see again”.
The Health and Social Care Committee accused the government and NHS England of being “reluctant” to acknowledge issues in the system and warned the “crisis” in general practice was “putting patients at risk”.
Problems are not being resolved with “sufficient urgency”, it said.
And the group of MPs added in the report that the government’s pledge for all patients to see a GP within two weeks would “not address the fundamental capacity problem causing poor GP access”.
The conclusions, which were partly written while new Chancellor Jeremy Hunt was chairman of the committee, lay bare a number of significant problems facing the sector, including “unacceptably poor” patient access and GPs being “demoralised”.
The committee has previously spoken about the “uberisation” of the family doctor service. One member Rachael Maskell said: “Seeing your GP should not be as random as booking an Uber with a driver you’re unlikely to see again.”
The MPs raised concerns about “continuity of care” and said the majority of GPs no longer had individual patients “lists”, and the ability to see the same GP has “worsened” as a result.
They also highlighted “unsustainable” workloads for GPs.
“General practice is the beating heart of the NHS and when it fails the NHS fails,” the report says.
“We know up to 90% of healthcare is delivered by primary care. Yet currently the profession is demoralised, GPs are leaving almost as fast as they can be recruited, and patients are increasingly dissatisfied with the level of access they receive.
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‘Unacceptably poor access’
“The first step to solving a problem is to acknowledge it, and we believe that general practice is in crisis … despite the best efforts of GPs, the elastic has snapped after many years of pressure.
“Patients are facing unacceptably poor access to, and experiences of, general practice and patient safety is at risk from unsustainable pressures.”
“Given their reluctance to acknowledge the crisis in general practice, we are not convinced that the Government or NHS England are prepared to address the problems in the service with sufficient urgency.”
The group says GPs are handling more appointments than ever with fewer staff.
The committee makes a number of recommendations, including scrapping an existing target and reward-based system as it had become a “tool of micromanagement and risks turning patients into numbers”.
It also suggested limiting doctor “list” sizes, looking at ways to support part-time GPs to work more hours, doing more to help hire new doctors, and resolving pension tax issues.
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Workload escalation
Committee member Ms Maskell added: “Our inquiry has heard time and again the benefits of continuity of care to a patient, with evidence linking it to reduced mortality and emergency admissions.
“Yet, that important relationship between a GP and their patients is in decline.
“We find it unacceptable that this, one of the defining standards of general practice, has been allowed to erode, and our report today sets out a series of measures to reverse that decline.”
Professor Martin Marshall, chairman of the Royal College of GPs, said those in general practice wanted to deliver “safe, timely and high-quality personalised care for patients”, but workload escalations meant the numbers of qualified full-time equivalent GPs had fallen since 2015.
“We need to see urgent action taken, not just to further increase recruitment into NHS general practice, but to keep hard-working, experienced GPs in the profession longer, delivering patient care on the front line and not bogged down in unnecessary bureaucracy.”
Shadow health secretary Wes Streeting said: “Patients are finding it impossible to get a GP appointment in the manner they want one.”
What’s being done?
A spokesperson for NHS England said the primary care workforce had been expanded by 19,000 since 2019 with more new roles such as assistants and digital help introduced from this month.
“Thanks to this additional investment, GPs and their teams have provided 10% more patient appointments this year compared to pre-pandemic, and we continue to implement plans to further improve patient access, experience and care.”
A Department of Health and Social Care spokesperson said all patients should be assigned a named GP, and practices must “endeavour to comply with all reasonable requests of patients to see a particular GP for an appointment”.
A statement added: “There are nearly 1,500 more full-time equivalent doctors working in general practice now than in 2019, and we are spending at least £1.5 billion to create 50 million more appointments by 2024 – alongside making changes to reduce the workload of GPs and free up appointments.”