Pressures in general practice and how we are responding to protect the services we can deliver.

Dear Patient

As you may be aware over recent years there have been huge increases in pressure on general practice and a significant reduction in funding. While nationally a lot of focus is always on hospital pressures and issues, the increase in demand and reduction in funding to general practice is much more marked.

Pressures such as the funding not matching nationally recommended pay rises and upcoming national insurance rise, along with business expenses rising with high inflation in recent years has meant we have less money to recruit staff. This is essential to deliver services and means we have to focus on those services we are funded and able to provide. The funding in the NHS is complex but to try and make it simple the hospital and community services get more money the more activity they do whereas general practice receives a relatively flat fee based on the number of patients. This flat fee has not increased to account for either inflation or the large amount of work which has been moved from hospitals to general practice. The activity done by general practice has more than doubled in the last 25 years for the same number of patients and income which has reduced as a proportion of NHS spend.

To protest this and make the case for a general practice fit for our patients, and one you deserve, we are joining in the national collective action. What this means for you as a patient is firstly that we will still be here for all your normal general practice needs. If for example you are unwell, have a new or ongoing health issue or need an annual review for your long-term condition then we are here providing the services you rely on.

However, in the past general practices have done a lot of work outside our contracts on behalf of other providers in the system who are paid to deliver it, usually because it is more convenient to have this done at the GP surgery. We cannot keep providing this on their behalf without funding to provide the resource and staff to do so. This includes blood tests and prescriptions which the hospital and specialists want (not ongoing repeat prescriptions). It includes certain services which GPs may have offered in place of hospital follow up such as ongoing monitoring for prostate cancer (to save a trip to the hospital), follow up of fatty liver problems (again a service the hospital is funded to provide), follow up of patient’s post-surgery and other such situations. We have sent a notice to our commissioners to state we will no longer be able to provide these services and intend to stop offering these and others in the future. It is hoped this notice will lead to new negotiations to properly resource these services.

We do understand the convenience and desire that general practice can support people to have these reviews as it is better for the patients and often, we can deliver high quality care in a much more timely and responsive way than secondary care. But without this being resourced then if we continue to offer this then the overall service we offer will further deteriorate and put increased risks for patients. This action is being taken by many practices locally and across the country and we hope it will drive the government to really look to resource a general practice to support the whole NHS.

We hope you understand and support us in this, please feel free to write to your MP in support of us.

Dr Walling and Dr Nathan