Bringing back the 48-hour target for GP appointments will only make a bad situation worse by transferring more pressure onto general practice – at a time when it is in crisis – which could have a profound impact on the safety of patient care.
The crisis that we are currently facing in general practice is just as bad as that in A&E, and has been caused by the accelerating diversion of resources from general practice to hospitals.
This crisis has the potential to bring the whole health service to its knees.
GPs now conduct 90% of the NHS contacts for just 8.39% of the NHS budget – the lowest percentage share of the NHS budget for general practice on record.
Between 2005/06 and 2011/12 (the latest year for which figures are available) the overall NHS budget grew by 18% in real terms, but funding for general practice fell by 8.3% in real terms, despite a growing population and spiralling health costs. Overall, general practice has lost a cumulative figure of £10.2bn over the last eight years.
This slump in funding is making it more and more difficult for GPs to deliver the services they want to.
We understand that patients are frustrated because sometimes they cannot get an appointment to see their GP, and a number of them then turn up at A&E who could be dealt with in general practice, but demand for general practice is outstripping resource and this will only get worse unless something is done to stop the transfer of funding from general practice to hospitals.
Our members tell us that they are already stretched to their limits and struggling to provide safe care for their patients. According to a recent RCGP opinion poll, many GPs are routinely working 11 hour days with up to 60 patient contacts in a single day. Another College opinion poll showed that 71% of GPs expect waiting times to worsen over the next two years and practices tell us that they are shedding staff due to funding cuts.
In order to stop the rot, the UK’s governments need to invest 11% of the NHS budget in general practice by 2017.
This would enable us to provide more patient appointments, more flexible opening hours, and more services for patients in their communities. It would also allow GPs to come up with new ways of working to manage demand and help alleviate pressures in other parts of the NHS.
We always felt that the 48-hour target introduced by the previous Labour Government, whilst well intentioned, distorted the smooth-running of general practice. GP access is extremely important but if you prioritise that over everything else, other services suffer and patients often end up worse off.
Dr Maureen Baker is chair of the RCGP