After years of pushing by the BMA and others, the media and the powers that be are finally getting the message: GP services are under unprecedented pressure and are struggling to cope with the incredible demand on them. Today sees the publication of an NHS England driven plan that lays out ten points to address the workforce problems bedeviling general practice – but will it be enough?
Firstly, and perhaps tentatively, let’s start with a positive. A few years ago, policy makers and NHS managers had their heads buried deep in the sand, denying there was any crisis in general practice and particularly with the workforce. It was an incredible state of affairs given the clear counter evidence on the ground. Finally though, not least because of the BMA’s Your GP Cares campaign and behind the scenes lobbying, a shift has taken place in the past 12 months. You can’t move at the moment in the media for promises of more funding for GP services and policy makers are constantly chattering about the problems facing GP practices, even if some like the CQC, continue to miss the point and heap unfair blame on GPs.
This new plan, heavily influenced by the BMA and others, also recognises that there is a specific problem with the GP workforce, both in terms of recruitment and retention. Last year was a nadir for both: a significant number of GP trainee positions were left vacant – as many as 400 in the first round – and seven out of ten GPs told the BMA in a survey they were thinking of retiring early. The simple result of this is that with fewer GPs, there will be fewer appointments for patients and shortage in services. Everyone loses.
However, as many GPs will know, words are one thing, translating them into actions on the ground is something else. Does this plan, full of more warm words, move us any closer to this?
Establishing a new scheme to encourage GPs who may be considering a career break or retirement, to remain working on a part-time basis is a very positive development. The proposed new induction and returner scheme will go some way in acknowledging the different needs of those returning from work overseas or from a career break.
However, while these developments are encouraging the BMA is not getting carried away, and neither should any GP. Implementation on all of this will be key and as yet, this has not been fleshed out. There are also many, many issues beyond the scope of this paper that we do not have clear direction on and which need to be addressed before general practice can truly be said to turn the corner. The promised £1.2billion for GP infrastructure remains unassigned and vague. Wider GP services are continuing to struggle and politicians of all parties have not realised that they cannot keep bombarding voters with promises that are undeliverable, whether it be 48 hour targets for GP appointments or extensive, longer opening hours for practices.
To answer the question at the start of this blog, the plan on its own is not enough. But it is an encouraging step forward that, from this day forward, the BMA will be working with and consistently challenging policy makers to turn into practical, deliverable solutions that will make a long term and sustainable difference to GPs on the ground.
Dr Krishna Kasaraneni is chair of the GPC education, training and workforce subcommittee and a GP in Sheffield