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A faulty production line

How the GP Forward View has split opinion

Dr Chaand Nagpaul - Power 50 2015

'NHS England have committed to investment which will reverse the unacceptable decline in general practice funding. This is a vital step as the proportion of resource in general practice will reach 11% of the NHS budget and beyond. We see this as a floor, not a ceiling, and believe that NHS England must ensure that resources follow where care is being provided going forward.

'It is vital that GPs and staff see tangible delivery against these commitments, so that the words are translated into action. GP practices must receive the immediate and urgent support needed, as well as the infrastructure for a sustainable future, which will attract younger doctors to become GPs, and enable existing GPs to remain working.

Dr Chaand Nagpaul, GPC chair

Dr Maureen baker - online

'Today’s announcement is a huge and important step in the right direction, and if implemented correctly, our profession, the wider NHS, and most importantly, our patients will reap the benefits.

'Crucially, it will send a loud and clear message to those about to embark on a career in general practice, and medical students considering it, that their future as a GP will be attractive and secure.'

Dr Maureen Baker, RCGP chair

Professor Steve Field 300x300


'We know that GPs are under increasing pressure with limited resources, increasing patient demand and a rapidly evolving health and care landscape and so, I am pleased this report sets out the increased support and further investment that they need to do their jobs well and to make sure their patients get the care they deserve.

'We look forward to playing our part in delivering the Forward View as we continue our plans to build on the regulatory model we introduced for general practices over eighteen months ago.'

Professor Steve Field, CQC chief inspector of general practice


Michelle Drage 300x300

'Today’s announcement falls far short of what is needed to address the challenges facing general practice in the Capital and beyond. GPs are in a state of emergency. Patients risk losing their GPs unless pressures on general practice are dramatically eased.

'General practice is at breaking point. That’s not safe for patients or staff.'

Dr Michelle Drage, chief executive Londonwide LMCs


Robert Morley 300x300

'Whilst it’s good news that the severity of the parlous state of general practice has belatedly been recognised and that all additional investment and many of the specific measures heralded in the document are to be welcomed, the increased funding announced here is still far too little, too late to resolve the catastrophic workload and workforce crisis facing the profession.'

Dr Robert Morley, GPC contracts and regulation subcommittee chair 


Clare Gerada 300x300

Clare Gerada 300x300

I’ve always said general practice goes in a twenty year cycle, and those twenty years are grim until something happens. I think this is the something, as long as the CCGs don’t steal it.

Professor Clare Gerada, former chair, RCGP


chris hewitt 2 online

chris hewitt 2 online

I believe that [this] could accelerate the demise of general practice as we know it. General practice needs a clear vision - we need a rescue package that clearly outlines pounds per patient and per patient contact for the core work of GPs.

Dr Chris Hewitt, Leicestershire LMC chief executive


Peter Swinyard 300x300

Peter Swinyard 300x300

As someone who is a fully paid up cynic about everything government tries to do to us, and the disasters that have met general practice in the last two or three years, this at least could be a turning point. We might look back and say ‘that was the first bit that started rebuilding general practice’. I hope I’m right.

Dr Peter Swinyard, chair, Family Doctor Association


Stephanie De Giorgio 300x300

Stephanie De Giorgio 300x300

I’m disappointed that the RCGP is in favour of the package – they were involved in helping create it and some of the work here is good but overall, it is not a rescue plan. It’s like putting a teeny round plaster on an exsanguinating patient.

Dr Stephanie DeGiorgio, co-founder of Resilient GP


Dr Nav Chana  Paul Stuart

Dr Nav Chana Paul Stuart

'Primary care organised around general practice has a pivotal role to play but it must be transformed to face challenges. We encourage this transformation to recognise the wider primary care workforce to support general practice to meet the health and social care needs of its population.'

Dr Nav Chana, chair of the National Association of Primary Care 


Zoe Norris 300x300

Zoe Norris 300x300

'To access the funding that has been announced, practices will have to jump through a lot of hoops and sign up to providing 7 day care. We are not being trusted to be given core funding'

Dr Zoe Norris, media lead, GP Survival

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Readers' comments (23)

  • our leaders are repeatedly confusing primary care with general practice. they are not the same things. the package they have announced is clearly for wider primary and community care, but it is presented as if it is intended for general practice. practices will see crumbs, if anything at all. Reserve your endorsements until you see new contract or DESes.

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  • Will take a Backward glance at the physiognomies above in a few years and reminisce with nostalgia how these people led primary care to it's grave. Every action they have taken, every word they have uttered has belied the hopes of the profession and further plunged it deeper into Hades.

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  • The priority now should be for NHSE to target those practices who are imminently about to fail for whatever reason (Carr Hill formula, poor QOF for whatever reason, Service Charge unreasonable, poor quality according to patient questionnaires) with the proviso that Partners are not taking home too much at the expense of quality. Years ago there was something called "Average Net Intended Remuneration". It should be reintroduced with an intended number of patients seen per day per GP - minimum and maximum. Take two sessions per day theoretically of 4hours and 10 minutes each. A Maximum of 18 patients per session and Minimum of 12 plus admin (including visits).

    Obviously one should not "fling money" at failing practices which may be being mismanaged, and therefore every practice that needs bailing out should be closely monitored in a facilitative fashion with co-operation from LMCs and NHSE.

    It is too late for me, I jumped before my old Practice failed. We were completely open with our accounts with NHSE, whose advice was simply to cut expenditure beyond what was necessary to remain viable

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  • Good will go into making us lot work 7days + out of hours, pay more to support CQC, GMC, create more standards and rules plus a few added conditions and cheating targets to make sure you miss or do work for free.

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  • Mayur Lakhani @8.36.

    Contributors here at Pulse invariably are to a degree self-selected but the disunity you describe has your opinion clearly in the outlier camp. Keeping an open mind is commendable but not so open that your brains fall out. Utilise past experience to reach a judgement and remember that pessimists are often simply the optimists who are in possession of the facts.

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  • Strongly support Mayur.These announcements are but a step in the right direction but are essential to turn a 1940s cottage industry into an integrated Primary Care system delivered from 21st century purpose-built premises.
    Cynicism is the easy route for idle apologists.The Government is in a deep,deep hole; an ideal time to smite them with your positive vision for the future.If you have not got one,stop whingeing, and book your ticket to NZ/Aus.

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  • Nice prose 11:05!

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  • Nigel's comments on reductionists and expansionists ring true here, though I suspect that there is a direct correlation between your distance from the cliff edge, and how expansionist you are in your views.

    There is a need for clear evidence that scale improves outcomes for patients - something I believe all the evidence currently refutes. When we draw conclusions before 'pilots' and 'vanguards' have started, its hard to have much faith in the methodology. Cynicism and idealism are both equally lazy forms of thought.

    I hold more sway by the work of Harry Longman than much of this uneducated guesswork.

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  • RCGP approve.

    Run away!

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  • Harley Thespaniel

    The level of prominence one achieves in one's field is proportional to the amount of crappy nonsense one emits.

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