Time to put patients first by investing in general practice.

Abstract

General practice is the cornerstone of the NHS, dealing with 90% of all patient contacts in our health services and helping to ensure the delivery of safe, effective patient care.1 Yet in recent years concerns have been mounting that a number of pressures facing GP surgeries are pushing UK general practice to breaking point. A central part of the problem is that practice workloads have been rising relentlessly for some time. NHS England estimates that surgeries in England dealt with 340 million consultations in 2011 to 2012, up from around 300 million in 2008 (the last year for which the most robust data is available).2 Anecdotal evidence, and the findings of a poll commissioned by the Royal College of General Practitioners (RCGP) in 2013, suggest that most GPs are now dealing with a workload of 40–60 patient contacts every day.3 Despite this growth in demand, general practice has suffered from a chronic lack of investment over the past decade, with its share of UK NHS spending now standing at a record low of 8.39%. In 2011 to 2012 around £8.7 billion was spent on general practice in Britain (including both local and national contracts, but excluding prescription costs): almost three-quarters of a billion pounds less, in real terms, than in 2005 to 2006. This represents an 8% drop at a time when the overall NHS budget in Britain has increased in real terms by 18%. General practice in Northern Ireland (for which comparable …