Ministers are ignoring “unsustainable” workload pressures and a growing shortage of medics in general practice, putting the safety of millions of patients at risk, MPs have said.
In a scathing report, the health and social care committee accuses the government and NHS England of being reluctant to acknowledge the enormous problems in the system. As a result, the crisis is not being tackled with anything like sufficient urgency, the MPs say.
At the same time, they say the government’s recent pledge that all patients can see a GP within two weeks will “not address the fundamental capacity problem causing poor GP access”.
The new report lays bare a number of significant problems facing the sector, including issues with “unacceptably poor” patient access, and GPs being demoralised.
The committee has previously warned of the “Uberisation” of the family doctor service, and in its latest report it says booking a GP appointment should not be like “phoning a call centre or booking an Uber driver who you will never see again”.
The MPs raise the alarm about continuity of care and say the majority of GPs no longer have individual patient lists, and the ability to see the same GP has worsened as a result. They also highlight GPs’ workloads.
“General practice is the beating heart of the NHS and when it fails, the NHS fails,” the report states. “We know up to 90% of healthcare is delivered by primary care. Yet currently the profession is demoralised, GPs are leaving almost as fast as they can be recruited, and patients are increasingly dissatisfied with the level of access they receive.
“The first step to solving a problem is to acknowledge it, and we believe that general practice is in crisis … despite the best efforts of GPs, the elastic has snapped after many years of pressure. Patients are facing unacceptably poor access to, and experiences of, general practice and patient safety is at risk from unsustainable pressures.
“Given their reluctance to acknowledge the crisis in general practice we are not convinced that the government or NHS England are prepared to address the problems in the service with sufficient urgency.”
The MPs make a number of recommendations, including scrapping target- and reward-based systems because these have become a “tool of micromanagement and risk turning patients into numbers”.
They also call for urgent action to resolve pension tax issues for doctors and make it easier for patients to get help when they need it.
Rachael Maskell, a Labour member of the committee, said: “The wider picture shows general practice as a profession in crisis, with doctors demoralised and overworked, the numbers recruited not matching those heading for the door. A reluctance by government and NHS England to acknowledge this crisis cannot continue and ministers must set out how they intend to protect patient safety in the short term.”
Prof Martin Marshall, the chair of the Royal College of GPs, said: “Today’s report recognises what the college has been saying for many years – that GPs and our teams are working under unsustainable workforce and workload pressures, and this is impacting on the care we are able to deliver to patients.
“GPs and our teams want to deliver safe, timely and high-quality personalised care for patients, but while workload escalates in terms of volume and complexity, numbers of fully qualified, full-time-equivalent GPs have fallen since 2015.
“We need to see urgent action taken, not just to further increase recruitment into NHS general practice, but to keep hard-working, experienced GPs in the profession longer, delivering patient care on the frontline and not bogged down in unnecessary bureaucracy.”
The shadow health secretary, Wes Streeting, said: “Patients are finding it impossible to get a GP appointment in the manner they want one. Seeing the same doctor for each appointment means better care for patients, but under the Tories this is becoming rarer and rarer.”
A NHS England spokesperson said: “GPs and their teams have provided 10% more patient appointments this year compared to pre-pandemic, and we continue to implement plans to further improve patient access, experience and care.”
A Department of Health and Social Care spokesperson said: “There are nearly 1,500 more full-time-equivalent doctors working in general practice now than in 2019, and we are spending at least £1.5bn to create 50m more appointments by 2024 – alongside making changes to reduce the workload of GPs and free up appointments.”
