We have today launched the full and final results of the BMA’s biggest ever GP survey, which carries with it the voice of 15,560 GPs. Only a foolhardy politician or policy maker would ignore its findings.
Going into the general election, all the party manifestos for the NHS are predicated on an expanded role for general practice and there being significantly more GPs. Regardless of how realistic this is, our survey provides a comprehensive picture of the views of the profession and provides clear messages to the incoming government.
Two weeks ago we published the first results, which underlined that inadequate consultation times and excessive workload are damaging the quality of care GPs can provide. Last week, the second release highlighted the alarming finding that one in three GPs intends to retire in the next five years and one in five GP trainees intends to work overseas after qualification. Worryingly, even if we were to recruit more GPs, these results warn that this will be more than offset by those leaving the profession, which would further deepen the workforce crisis in general practice.
The survey shows that what GPs value most are exactly the same factors that are key to patients: continuity of care, trust and confidentiality, and the holistic care that is the cornerstone of general practice.
Unrealistic headline pledges of seven-day services or quicker access will only exacerbate recruitment and retention problems, since this will demotivate GPs further by requiring them to focus on an access-driven agenda at the expense of providing personalised continuity of care.
The survey identified the following key problems and deterrents to potential recruits:
- excessive workload
- unresourced and inappropriate transfer of work into general practice
- lack of time with patients
- and overregulation.
On contractual matters, the survey found overwhelming support (82 per cent) for a national GP contract. Other key findings were as follows:
- Eight out of 10 GPs support independent contractor status
- Just over half would like the QOF (quality and outcomes framework) to shrink further, with the money released being transferred into core GP funding
- Only one in 20 feels APMS (alternative provider medical services) contracts offer value for money or continuity of care, and less than one in 10 thinks they offer good care.
The survey also described the environment in which GPs want to work:
- Two in three are in favour of GPs owning their own premises, but others are open-minded regarding working in third-party facilities
- Three in four would like to work in primary care premises with other community-based staff and services
- Three-quarters would like to work in premises with access to primary care hubs, with diagnostic facilities and extended out-of-hospital services.
On new models of care:
- 40 per cent of GPs are already working in collaborative networks or federations
- More than half (52 per cent) are in favour of practices working collaboratively in networks or federations with other healthcare professionals, along the lines of the MCP (multidisciplinary community provider) model in the NHS’s Five Year Forward View
- Only one in ten would like to work in a single integrated organisation comprising general practice, hospitals and community services, similar to the PACS (primary and acute care system) model in the Five Year Forward View.
On use of technology:
- 86 per cent of GPs agree that telephone consultations are an effective way of consulting with patients where appropriate
- Almost two-thirds (63 per cent) believe that telephone consultations can be an effective way of managing demand as an alternative to face-to-face consultations
- Most GPs voice concerns about the use of email consultations. Seven in ten (71 per cent) are concerned that email consultations would increase their workload, and almost two-thirds (63 per cent) are worried about the clinical limitations.
We will be presenting these powerful findings to the new government with a call to: end empty promises; assure the future of general practice by designing it around the realities facing GPs; and reflect GPs’ hopes and concerns.
The NHS is in a parlous state and even politicians appear to agree it needs a strong foundation in general practice. This needs sustained investment and development. The imminent election provides a golden opportunity for a new government to get it right for once, by recognising the true value and worth of general practice and how it can provide a real solution to many of the pressures in the NHS.
We will do all we can to get this message across after 7 May.
For the latest news, visit bma.org.uk/gpc