Incoming CEO of Londonwide LMCs Dr Lisa Harrod-Rothwell on the necessity of the Government prioritising general practice in the NHS
When I joined Londonwide LMCs in 2016, general practice was already in crisis. Nine years on, the situation has deteriorated. Successive governments have made and broken promises, leaving GPs and their patients in a constant state of uncertainty. Whether it’s stagnant funding, a failure to retain a highly skilled workforce, or bureaucratic barriers that prevent innovation, general practice has been pushed to the sidelines of the NHS for far too long.
Yet this part of the system is not peripheral – it’s fundamental. Primary care is responsible for over 90% of patient interactions within the NHS. Despite this, the share of NHS funding allocated to primary care has failed to keep pace with demand, inflation, and rising costs. The result is GP surgeries struggling to keep their doors open, stretched beyond capacity, and in many cases, forced to close altogether. With each closure, patient access to care diminishes, pressure on hospitals increases, and the core mission of the NHS – to provide universal healthcare, free at the point of use – is undermined.
This is all happening at a time when patient numbers are rising, and the number of full-time equivalent GPs is falling. The Government has acknowledged the problem and even offered a cash injection, first announced by the health secretary in December. While this is a welcome step – and more than we’ve seen in years – it’s difficult to celebrate when it’s immediately counteracted by a hike in employers’ National Insurance contributions. The Institute of General Practice Management has estimated this tax change alone could cost the average surgery around £20,000 a year – and likely more in high-cost areas like London.
The situation has become untenable for many practices. In some of the capital’s most deprived areas, where demand is highest and operating costs are steepest, practices are hanging on by a thread. Financial pressures are pushing GPs out of the profession altogether – and when surgeries close, patients pay the price: longer waits, fewer appointments, and reduced continuity of care – a core strength of general practice that patients overwhelmingly value. A YouGov poll from 2023 showed that 95% of patients want a family doctor who can offer long-term, personal support. That continuity is only possible when we support general practice to thrive, not just survive.
General practice doesn’t need platitudes, it needs action – and the upcoming NHS 10-year plan must deliver clear, sustainable investment in general practice. It must tackle the postcode lottery that leaves practices in poorer areas disproportionately underfunded and under-resourced. It must give GPs the freedom and autonomy to innovate, deliver preventative care, and shift services away from overstretched hospitals into local communities.
The 10-year plan also needs to recognise that we will never solve the workforce crisis through recruitment alone. Retention matters. Too many newly qualified GPs are leaving general practice altogether, driven out by burnout, bureaucracy, and a sense that they can’t deliver the care they trained to provide. Fair pay, manageable workloads, and real career progression must be part of the solution.
As CEO-designate of Londonwide LMCs, I’ve been meeting with MPs across the capital, urging them to put general practice at the centre of their work to tackle the NHS crisis. During the general election, the Labour Party committed to doing just that. Now is the moment to turn those promises into policies – and into funding.
Our GPs are some of the most dedicated and skilled professionals in the health system. They want to provide excellent care, but they can’t do it without the infrastructure and investment to support them. Without general practice, the NHS simply cannot function. And without immediate, meaningful dialogue and recognition of the value of authentic general practice, we risk losing a generation of family doctors – and with them, the future of patient care.
It’s time to stop managing the crisis. It’s time to rebuild general practice.
Dr Lisa Harrod-Rothwell is a practising GP and the incoming CEO of Londonwide LMCs.
