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20 October 2022

General practice is in crisis – and the government is failing to act

The Health and Social Care Committee has published a report calling for urgent reform.

By Zoë Grünewald

MPs have called on the government to acknowledge a crisis in general practice and urgently set out steps to protect patients.

The House of Commons Health and Social Care Committee has today published a scathing report on the future of general practice, which accuses leaders of failing to act on the importance of continuity of care and an acute shortage of GPs.

Who chairs the Health and Social Care Committee?

The Health and Social Care Committee is a parliamentary committee that sits within the House of Commons. It is made up of a group of cross-party MPs who scrutinise government policy relating to the National Health Service, social care and health policy. Up until last week the committee was chaired by senior Conservative MP Jeremy Hunt, who is now serving as Chancellor of the Exchequer. It is against the rules for a member of the government to serve in a parliamentary select committee.

Nominations for the new chair opened on Monday 17 October and close at noon on Tuesday 1 November. If there is more than one candidate, there will be a ballot on Wednesday 2 November and the Speaker will announce the results later that day.

What does the report say?

The committee’s report concludes that the government and NHS England have failed to acknowledge the crisis in general practice and says that the committee is not convinced there is adequate preparation to deal with the problem.

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The report says that although general practice is “the beating heart of the NHS”, the profession is “demoralised” and “GPs are leaving almost as fast as they can be recruited”, meaning there are not enough GPs to meet the increasing demands of an ageing population.

The committee heard that many GPs are working harder, facing burnout and leaving the profession, and that the government was not on track to meet its target to recruit 6,000 additional GPs by 2024.

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Health and Social Care Committee member Rachael Maskell, Labour MP for York Central, said: “The wider picture shows general practice as a profession in crisis, with doctors demoralised and overworked, and 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.”

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The committee also advocated for better continuity of care and the “personal list” model. This means that individual GPs would have an assigned list of patients and would be responsible for delivering the majority of their care, enabling practitioners to be more efficient and improve patient experience. The report criticises the government for not following this model, stating that there is “clear international and UK research showing that seeing the same GP over a long period of time leads to fewer hospital visits, lower mortality and less cost for the NHS.”

Seeing your GP “should not be like phoning a call centre or booking an Uber driver who you will never see again: relationship-based care is essential for patient safety and patient experience”, the report said.

“Our inquiry has heard time and again the benefits of continuity of care to a patient, with evidence linking it to reduced mortality and emergency admissions,” Maskell added. “Yet that important relationship between a GP and their patients is in decline. We find it unacceptable that this, one of the defining standards of general practice, has been allowed to erode, and our report today sets out a series of measures to reverse that decline.”

What does the report recommend?

The report makes a series of recommendations for the NHS and Department for Health and Social Care to prioritise now, including that the government and NHS England must acknowledge the decline in continuity of care in recent years and prioritise its reversal. It also says that NHS England should introduce continuity of care to be reported by all GP practices nationally by 2024, and that personal lists should be reimplemented from 2030 onwards. The report also recommends that an additional 1,000 GP training places should be created each year with government funding.

What are the next steps?

The government should respond in writing to the reports of select committees within two months of publication. The response will be published on the committee’s website.

You can find out more information about the inquiry here.

[See also: Why are Covid-19 cases rising again?]

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