Health chiefs' 'complacency' over family doctor pressures slammed


Health officials have been slammed by MPs for being "complacent" about the increased pressures faced by family doctors.

The Department of Health and NHS England have also "failed" to ensure that there are enough GPs to keep pace with growing demand, the Public Accounts Committee (PAC) said.

Patients' ability to get an appointment with their GP has "consistently declined" in recent years, according to the latest PAC report.

In some areas it is harder to get an appointment with a family doctor because staffing levels vary significantly across the country, the Access to General Practice in England report states.

There is also an "unacceptable variation" in patients' experiences of getting and making appointments, they said.

NHS England and the Department of Health "do not have enough information on demand, activity or capacity to support their decisions on general practice," they added.

The authors wrote: "In recent years the Department of Health and NHS England have failed to ensure that staffing in general practice has kept pace with growing demand.

"They appear to have been complacent about general practice's ability to cope with the increase in demand caused by rising public expectations and the needs of an ageing population, many of whom have multiple health conditions.

"The Department and NHS England now seem to recognise the urgent need for action and they envisage significant changes in general practice over the next few years."

The MPs set out a series of recommendations for health officials, including: setting out how they plan to improve recruitment and retention of GPs; assessing how they can improve access for patients; and working to help provide clear information to patients about where they can access the right medical care.

PAC chairwoman Meg Hillier said: "There is a looming crisis in general practice. For too long staffing levels have failed to keep pace with the growth in demand and too little has been done to close the gap.

"Experienced GPs are quitting while training places go unfilled; there are alarming variations in the experience of different groups of patients, and in some cases even basic information is hard to find - piling additional pressure on other parts of the health service.

"These are serious problems requiring serious solutions. Government accepts action is necessary but we must have confidence this action will result in the best possible outcome for taxpayers.

"For that reason our committee has set out a series of measures we expect Government to act and report on by the end of this year."

Dr Chaand Nagpaul, chairman of the British Medical Association's GP committee, said: "This important independent report vindicates the BMA's repeated warnings about the depth of the crisis confronting general practice.

"GP services are being overwhelmed by rising patient demand, especially from an ageing population with complex, chronic medical conditions that require longer and more frequent appointments to deal with. GP practices simply do not have the staff or resources to cope with this pressure.

"As the report indicates, this alarming reality is a direct result of successive governments failing to build a GP workforce that can provide high quality care to a changing population with different needs, and a health system where large swathes of care is being moved out of hospitals into the community without the necessary funding being made available to meet this need.

"The BMA has repeatedly called on the Government to implement an urgent rescue package for general practice to ensure the survival of a service that provides care to a million patients daily."

Dr Maureen Baker, chairwoman of the Royal College of General Practitioners, said: "GPs and our teams are making an estimated 370 million patient consultations a year - 60 million more than five years ago - to meet the increasing demand of our growing and ageing population, yet the number of family doctors over this period has remained relatively stagnant.

"This toxic mix of increased demand and plummeting resources is leading many established GPs to leave the profession, and not enough medical students are choosing a career in general practice to take their place.

"It is essential that initiatives are urgently implemented to 'recruit, retain and return' thousands more GPs and practice staff - as outlined in the 10 point plan to build the GP workforce that we launched last year with NHS England, Health Education England and the BMA - to deliver safe patient care right across the country."

A Department of Health spokeswoman said: "As this report acknowledges, we are taking wide-ranging action to improve GP access as part of our commitment to a safer, seven day a week NHS.

"We have agreed a new GP contract that will see record investment in general practice and we are enabling patients to see a GP at evenings and weekends, as well as improving access through telephone and video consultations. The number of GPs recruited rose last year and we will boost numbers further with 10,000 new primary care staff, including 5,000 doctors in general practice, by 2020."