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Pulse 2019 review: What the election results mean for GPs



In the lead-up to the general election, the NHS barely made it out of the headlines.

Unsurprisingly, it was subject to the usual clamour of promises and accusations from all sides.

But now the dust is starting to settle, what will general practice find in its Christmas stocking – a pot of glistening gold or an old lump of coal?

This year, the average wait to see a GP exceeded two weeks for the first time, and health secretary Matt Hancock has promised to speed things up. This would happen in the form of an extra 6,000 GPs by 2023/24.

But, when you factor in that in 2015 the Tories promised to increase GP numbers by 5,000 by next year – and that, in reality, numbers have fallen by 1,000 in that time – we’re still way down on the GP workforce.

More than that, it turns out that half of the 6,000 newly pledged GPs will actually be trainees – and they won’t be fully trained and in post in five years’ time.

In the best-case scenario, there will be 3,000 fewer fully trained GPs in three years’ time than the government said we’d have now.

But the best-case scenario seldom pans out, and it doesn’t allow for the retention problems general practice has continued to have in recent years.

According to NHS primary care director Dr Nikita Kanani, only one in every three GP trainees will go on to become a full-time equivalent GP.

A King’s Fund study paints an even bleaker picture, suggesting that just one GP trainee in 20 sees themselves working in general practice in 10 years’ time. And just one-quarter see themselves working as a full-time GP in a year.

Moreover, around 30% of GPs have reduced their hours in the past year. All things considered, the Tory vision for a flourishing GP workforce is nothing short of a pipe dream.

There’s not an iota of clarity on how the Conservatives intend to improve retention, beyond vague whispers about reducing pressures on staff through triage and technology.

Some of the strain in general practice could be taken by other healthcare professionals, and the government plans to plough £300m into boosting these staff numbers by 6,000. This is on top of the 20,000 pledged as part of the recent GP contract.

But again, the details are lacking so we’re none the wiser as to how this will happen in reality.

The party has pledged £4.4bn per year in long-term general practice funding – which sounds laudable. The BMA, however, suggests that overall NHS funding will fall short by £6.2bn by 2023-24.

That’s a lot of money that needs to be found down the back of the sofa.