NHS 10-year plan must commit to increasing GP investment each year, says RCGP

The RCGP has called for a ‘primary care investment standard’ to be included in the upcoming NHS 10-year plan, ensuring that the Government and ICBs increase their spending on general practice each year.

To fulfil the Government’s ambition to ‘shift care from hospitals into the community’, the college warned that a ‘significant uplift’ in primary care funding is ‘essential’, after years of underfunding of general practice.

It published a document outlining its recommendations to the Government as it refines details about how the plan, which is expected in the next few days, will be implemented in the coming months and years.

As part of this the RCGP said that a higher proportion of funding should be allocated to primary care with resources ‘optimised in the community’ to better care for patients with complex illness and multiple conditions.

It comes after NHS England said that the plan will be ‘GP-centric’ but it will not come with huge shifts of funding from secondary to primary care immediately.

And RCGP chair Professor Kamila Hawthorne said that the college has already been warned that ‘the resource envelope will not increase’, but that there is an expectation that the NHS budget ‘will show a shift of its own’, from secondary to community care.

Some details of the plan have already been revealed, including a review of the Carr-Hill formula for GP funding.

The college said: ‘To “shift care from hospitals into the community” a significant uplift in primary care funding is essential, after years of underfunding of general practice.

‘This will not only be more cost effective but will also deliver care where patients want it. RCGP is calling for a Primary Care Investment Standard, ensuring that both central government and ICBs increase their spending on general practice and primary care each year.’

In a message to GPs last week, Professor Hawthorne said: ‘While we are being warned that the resource envelope will not increase, we are still expecting that the NHS budget will show a shift of its own, from secondary to community care, as resource has to follow the patient for this to work.

‘But the discussions behind the scenes continue and we will continue to push DHSC to ensure this shift happens as quickly as possible.’

On neighbourhood care, the college added that ‘one model or size will not fit all’ and that there will need to be a national vision for neighbourhood services ‘accompanied by local flexibility’ so that neighbourhood working can be tailored to the needs of local populations, while ‘avoiding a postcode lottery’.

As part of its submission to the 10-year plan consultation at the end of last year, the RCGP warned that removing urgent care from GP practices as part of plans for neighbourhood health centres could ‘disrupt relationships’ with patients and lead to worse outcomes.

It said that practices should retain ‘a key role’ in helping to triage and refer patients, identifying which other services they might need and helping them to navigate the care system, acting as ‘conductors of the orchestra’.

The document added: ‘GP teams are at the hearts of their communities, and we need to play a key role in shaping new community services to get the best for our patients. General practice staff need to be part of future decision-making at all levels of the NHS system.’

The RCGP also mentioned that the Government has committed to ‘training thousands more GPs’ as part of the chancellor’s spending review earlier this month.

According to the Treasury announcement, which was light on detail, ‘thousands more GPs’ will be ‘trained’ with the money which will see real terms day-to-day spending on NHS services increase by 3% on average.

But the RCGP pointed out that training capacity is ‘already stretched’ after years of underfunding, both for physical space in practice buildings and the number of trainers, which ‘must be addressed as a priority’.

It added: ‘More employment opportunities for GPs are needed for when they get out of training, and fully-funded retention schemes are vital to keep the GPs we have, at all career stages.

‘It will also be important to ensure there are sufficient staff working across the community, such as district nurses.’

A challenge for some smaller-sized GP practices is the lack of ‘back-office’ administrative capacity such as HR and IT, the college warned.

It added: ‘There is now an opportunity through new commissioning arrangements of neighbourhood services, to support smaller providers by procuring common IT systems within locality footprints. This could help to facilitate digital integration and achieve better value for money.’

Earlier this month, the RCGP suggested that the plan is likely to be positive for general practice.