General Practice in Crisis Information for Patient Participation Groups

GP Crisis  Current Challenges  Demand  Recruitment  Retention  Trainees  Funding  Solutions  GP Forward View  What can the PPG do?

Current Challenges- demand  Demand for general practice rising faster than funding  Patients cannot get to see their GPs when they need or want to  An ageing population  General practice carries out 90% of NHS clinical contacts annually  There are more patients with 3 or more long term conditions such as diabetes, heart disease, lung disease, arthritis etc  1.9m estimated to rise to 2.9m by 2018  As a result- practices are seeing patients twice as often as in the past-the average patient attends their surgery 8 times per year, up from 4 times per year a decade ago.  In 2008 general practices carried out 300 million consultations, in 2015 this had increased to 370 million

Current Challenges- recruitment  Nationally, over 8% of GP posts are unfilled  NHS England estimates that the safe number of patients per GP is 1750  Using this ratio there should be 415 GPs in Lincolnshire  There are 340 GPs, a 75 GP gap  The average doctor patient ratio in Lincolnshire is 1:1900, and in some practices this is as high as 1:2400  This shortfall is partly made up from advanced nurse practitioners, nurse practitioners, practice nurses and paramedics

Current Challenges - retention  Nationally 34% of GPs plan to retire in the next five years, and a further 17% are planning to reduce their clinical commitment  40% of GPs are currently aged 50 years or over  In Lincolnshire 30% of practices have at least one doctor retiring in the next 12 months

Current Challenges- trainees  Nationally, only 88% of GP training places are unfilled, though in Lincolnshire this figure is 28%  21% of GP trainees plan to emigrate after training

Challenges- funding  General practice receives only 7.29% of the NHS budget, a fall from 10.4% in 2004/5  Total NHS funding has fallen to 7% of GDP  NHS funding is way behind other European countries- Netherlands, France and Germany- 11%, Greece 9%

Challenges- funding  One attendance at A&E costs the NHS £124. One outpatient appointment £111  The cost per patient to be cared for in general practice FOR A WHOLE YEAR is only £136

Possible solution- increase funding for GP  Increase funding for the NHS to 11% of GDP  Increase funding for general practice to 11% of the NHS budget (not bad for 90% of consultations)  Improved access to general practice reduces A&E attendances and hospital admissions saving £315 - £447 million per year in the UK

Potential solution- New Models of Care  To make significant savings to the NHS budget, new models of care must be created, which provide efficient care closer to home, this can best be achieved by integration of services, with general practice in the central coordinating role  NHS England Five Year Forward View  Transformation to new models of care needs funding

GP State of Emergency: Is it Safe?

General Practice Forward View  NHS England has published a plan to “rescue” general practice, this is the GP Forward View  The GPFV proposes increased funding for general practice by 2020, but not for the NHS as a whole  The GPFV proposes to increase GP workforce by 2020, but does not set out how these new GPs and allied health professions will be found  None of the measures in the GPFV can happen now, when we already have a crisis

What can the PPG do to help?  Spread the message to other patients that general practice is in crisis  Lobby your MP- letters from concerned constituents can affect significant change