This site is intended for health professionals only

At the heart of general practice since 1960

NHS England 'should spend more on general practice'

NHS England needs to increase spending on primary care in order to achieve the desired shift in patient care out of hospitals, says the policy director of the Nuffield Trust.

In an exclusive interview with Pulse, Dr Judith Smith said that at the moment GPs feel constrained by workload, funding pressures and ‘being stuck’ in the current general practice service model.

Speaking after the think-tank’s joint report with the King’s Fund on the future of general practice, which suggested a new alternative GP contract is developed to incentivise larger-scale working, Dr Smith said that this would require general practice taking a larger chunk of the overall NHS budget - than the current 9% - in the longer term, alongside investment in workforce and premises.

She said: ‘Primary care spending has been flat and even reducing as an overall percentage of NHS funding in the recent past, and I think as we look forward and there is a requirement for primary care to take on more if we look at changes to how our hospitals might run. We have to think seriously about how primary care is funded and supported.

‘I think we would be looking at a phased [shift of resources into primary care] over time, matched to workforce and premises development, and wider changes being made to hospital care and configuration.

But she warned that it was unlikely the NHS would increase spending without GPs delivering more.

She said: ‘It is actually not just putting in money for more of the same, but actually it is going to have to be organised and designed in a different way to offer a wider range of services to patients. So, yes, more investment, but for something different and more up-scaled.’

Dr Smith also warned it will be difficult to achieve the scale required without relieving the pressure on GPs who at the minute feel ‘stuck on a treadmill’ of workload and funding constraints.

Dr Smith said: ‘I think GPs are up for this. They are very conscious about how services could and should be, but feel constrained about the current service model that they find themselves in.

‘For many at the moment they feel I think trapped on a treadmill of workload, of constrained funding, and so what we heard quite clearly in our research for this work was that people need the time and space to get off the treadmill for a little while, think about how they would like to design and deliver primary care differently for their local populations.’

‘What we are saying is that we need, from NHS England primarily, some support in place to make some resources available for groups of practices for where they’ve got some ideas that they’d like to take forward. To perhaps give them some space and time, to buy out some time for those leaders to reflect and plan and so they can actually design their future as they want it to be for their patients and their population.’



Readers' comments (3)

  • This is just so obvious. Confederating will be a major political exercise and the financial settlements between merging practices will need to be mutually agreed. Very hard not to get on with this when we know we are efficient and cheap and have the monopoly on those rare NHS commodities: knowledge of the patients, generalist experience, continuity, central oversight of patient care (and the only joined-up records), a commitment to outcome on patient care, willing to work after 5pm.

    Unsuitable or offensive? Report this comment

  • 2:15 I can only assume you are trying to be sarcastic.

    Either way, most iof your colleagues are no more all-knowing and hardworking than everyone else. And I seem to remember you lot all voted to opt out of out of hours...

    Unsuitable or offensive? Report this comment

  • This comment has been moderated

  • And I seem to remember you lot all voted to opt out of out of hours...


    Learn the facts please. Offered 6K for OOH work was like being asked to work for less than minimum wage- no brainer.

    no more all-knowing and hardworking than everyone else.

    Great- that's the GP shortage sorted then- welcome to General Practice.
    My non medic mates think it's a joke that I have to get them to pick my kids up because I can never guarantee leaving work on time. We have little or no control over workload.

    Unsuitable or offensive? Report this comment

Have your say