Leading GP raises concerns over sustainability and transformation plans


A leading GP has raised concerns that plans which are being drawn up to make the NHS sustainable over coming years "barely acknowledge" the role of family doctors.

Despite 90% of NHS interactions happening in GP practices, some of the new sustainability and transformation plans "barely acknowledge general practice at all", the leader of the Royal College of GPs said.

The proposals are being drawn up across England to meet significant cuts.

The plans aim to show how services in each local region will evolve and become sustainable over the next five years.

But the proposals, which are expected to be finalised this month, have been shrouded with controversy, with some saying they are used as a cover for service cuts and hospital closures.

College chairwoman Dr Maureen Baker said that "very few" of the plans contain specific pledges to earmark extra funding for general practice.

And GPs are reporting that they are being pushed out of the process - including many official RCGP representatives, the College said.

Dr Baker also expressed concerns that some of the plans were just being used to plug deficits in hospitals.

Dr Baker will tell the RCGP's annual Primary Care Conference in Harrogate: "The STPs will play a crucial role in shaping the future development of the NHS over the next five years. However, strengthening general practice should be at the heart of what they are about.

"But in many areas RCGP local representatives are struggling against an agenda that is focused on plugging ever increasing hospital deficits.

"This is a false vision which may seem to offer short term gain, but if general practice isn't supported then there is no system transformation and we will very quickly be back where we started."

She will add: "Based on the limited information about STPs that has been published, very few contain specific pledges to earmark extra funding for general practice. Some barely acknowledge general practice at all.

"If STP plans fail to deliver the funding for general practice - from the Sustainability and Transformation Fund - then the family doctor service stands to lose up to £760m in 2020/21.

"So, I call on (NHS England chief executive) Simon Stevens to require all STPs to publish their financial plans, and to make crystal clear that unless they commit to invest more in general practice, through the Sustainability and Transformation Fund, their plans will be rejected and responsibility for the Fund regionally will be withheld from the non-compliant STPs."

Meanwhile, RCGP analysis of spending of local health authorities shows that they are on track to underspend their funding allocation on general practice by £33 million in the current financial year, she will tell delegates.

"This is not loose change down the back of a sofa," she will say.

"It is real money that could make a real difference.

"The failure to spend money earmarked for general practice on general practice is a national disgrace.

"And it is high time that CCGs realised that general practice is a vital component of the local healthcare system - not a fringe activity that can be used as a way of trimming the fat from their budgets."

Dr Chaand Nagpaul, chair of the British Medical Association's GP committee, said: "General practice is at breaking point. Many local GP surgeries are struggling to provide even basic care to their patients as they face a climate of shrinking budgets, staff shortages and rising workload.

"The Government made clear promises in its recently announced General Practice Forward View to properly invest in GP services after a decade of neglect.

"It is vital that the Government acts to deliver on its pledges, and ensures that patients can receive safe, timely and quality care from their GP surgery."

Labour's shadow health secretary Diane Abbott said: "The exclusion of GPs from the sustainability and transformation plans is deeply worrying.

"GP services are a vital part of a properly integrated NHS. Without including them, the Tory Government risks deepening chaos in the health service."

An NHS England spokeswoman said: "We are working hard to relieve pressures on GPs and this includes increasing funding for general practice by £2.4bn a year by 2021 - a 14% real-terms increase.

"This demonstrates our commitment to strengthening GP services and as part of these efforts we have highlighted that local areas, through their Sustainability and Transformation Plans, need to set out how they will further support general practice, both now and in the future."