The House of Commons Health Committee recently invited written submissions as part of an inquiry into the challenges affecting primary care services in England.
The Nuffield Trust’s submission follows the terms of reference outlined by the committee, drawing on our existing analysis and perspectives to offer insights in each of the six areas within the scope of the inquiry: quality; demand and access; funding; commissioning; future models of care; and workforce.
The Health Select Committee’s Inquiry comes at a crucial time for primary care. We are facing a workforce crisis in general practice, with record numbers of GPs retiring or leaving the profession, and training places unfilled. At the same time, spending on general practice has stagnated, and the potential offered by other professionals, such as pharmacists, to help transform care has not yet been realised.
Our response to consultation notes that concerns are now mounting about patient access to their GP. Patients are waiting longer for appointments and finding it harder to get in touch with their local surgery, although the majority of people do still report a good experience when they visit their GP.
We point towards our previous work in primary care, which shows that, alongside the official ‘vanguard’ areas experimenting with new models of care, many other areas are pursuing approaches based on the same principles. We express concern that while the scaling-up of general practice has been a trend we have observed over the last decade, the evidence base around the impact of such models on quality of care, patient and professional experience and service innovation is still emerging.
Among other things, this contributes to uncertainty over the future of the clinical commissioning group (CCG) model: as GPs become more involved in the new care models proposed by the Five Year Forward View, their willingness to devote valuable time and energy to their CCG is starting to wane.
These issues, alongside the vulnerability of spending lines affecting primary care in the November spending review and the wider funding issues throughout the NHS, leave primary care services at a critical juncture.
Nuffield Trust (2015) Health Committee Inquiry Submission: primary care.