‘Patients will lose out if general practice isn’t recognised’

A comment on our indicator updates on GP services.

Blog post

Published: 19/09/2016

We invited Maureen Baker, chair of the Royal College of General Practitioners, to comment on our latest indicator updates, which report on GP Patient Survey data. You can read our summary of the indicators here.

The GP Patient Survey is an excellent way of gauging what our patients think of general practice at any point in time, and it is testament to the hard work and dedication of GPs and their teams around the country that overall satisfaction ratings are consistently high.

General practice is currently in a tough place. Whilst GPs and our teams deliver 90% of NHS patient contacts, our service currently receives just 8.32% of the overall health service budget. This varies across the UK: 8.48% in England; 8.15% in Northern Ireland; 7.45% in Wales; and just 7.39% in Scotland.[1]

We also have a severe shortage of GPs. Despite our workload escalating – by 16% over the last seven years according to a recent study in The Lancet – the number of family doctors has risen nowhere near in step. 

Investment required

The College has used our own analysis of the GP Patient Survey to highlight these trends, and get the messages across that investing in general practice is actually the most cost-effective way of keeping the health service sustainable, but also how failure to invest in general practice poses a serious risk to patient safety.

As a result, NHS England announced the General Practice Forward View in April, which the College sees as a lifeline for our service and recognition of the essential role general practice plays in the health service.

In all there are over 100 pledges, but over-arching are the promises of £2.4bn extra a year for general practice from 2020 - at least 10% of the overall NHS budget, but our own financial analysis forecasts that this could be closer to 11% - 5,000 more GPs, and 5,000 other general practice professionals by the end of the current parliament.

In Scotland, Wales and Northern Ireland, the College is continuing to call for more resources and more GPs through our Put patients first: Back general practice campaign, with some encouraging results.

Access concerns

The long and short of it is that if general practice is not recognised for the crucial role it plays in delivering high quality patient care right across the UK, then it will be our patients who lose out. The most obvious example of this is waiting times. Our analysis of the latest GP patient survey shows that patients could be waiting a week or more for an appointment with their GP or practice nurse on nearly 100m occasions.

The time we have with patients is also a concern. Our patients are living longer and with multiple conditions, both mental and physical, making the standard 10-minute GP-patient consultation increasingly unfit for purpose.

With this in mind, we’re incredibly grateful for the understanding our patients show to us. The latest survey found that 85% of patients said their GP gave them enough time during consultation, and 79% said the same about their practice nurse.

Likewise, the fact that GPs are making so many consultations every day, and dealing with more complex conditions during these consultations, often means that we’re not running to schedule. Yet, according to the latest survey results, only 26.7% of patients waited 15 minutes or more to see their GP or practice nurse; only a quarter thought they had to wait ‘a bit too long’, and just 9% thought they had to wait far too long.

Not only does this show that GPs and our teams are going the extra mile in a very difficult situation, but that our patients recognise the pressures we are under, and appreciate the care we deliver regardless.

What we can also tell from the GP Patient Survey results is that satisfaction with GP out of hours services is good. It’s a shame this question has dropped out of the survey, but in 2014/15, the last time a question was asked, nearly 70% of patients who accessed GP out of hours services were satisfied with the care they received.

Contrary to what you might read in the media, out of hours care led or run by GPs accounts for 59% of all out of hours services in the UK.

Despite this, only 45% of patients who responded to the survey knew how to access GP out of hours services. This is what we should be tackling - not pushing for routine seven day GP services, when our service is already under such intense resource and workforce pressures. We need our patients to know where to turn when they are sick outside of routine hours – and we need more integration between in and out of hours services.

Quality in general practice

So what can we learn from the GP Patient Survey, and how can we use the results to improve quality in general practice? The answer is simple: give us the tools to do our job properly. We need more funding; more GPs and practice staff so that we can spend more time with patients; and better integration of services.

If the GP Forward View is implemented effectively in England, we’re almost there, and we need to push for an equivalent settlement in Scotland, Wales and Northern Ireland. This way our patients – and the NHS – across the UK can benefit from a strong, robust general practice service.

Then we will see patient satisfaction ratings soar even higher.

1. Figures taken from analysis of NHS DigitalNHSEISD ScotlandStatsWales and Health and Social Care Board.