Dear Professor Grant,
Thank you for your recent response to our letter regarding the provision of occupational health services for GPs, and for your support for our campaign.
We were delighted that NHS England has recognised the intense pressures on the profession and has agreed to provide high quality occupational health support if GPs need it. This is a huge step forward from the patchy provision previously provided by PCTs, and will enable GPs to effectively support their patients and take on the transformation that NHS England wants to see from its ‘Call to Action’ in primary care.
However, we are keen that this should be the first stage in a wider reassessment of how the NHS can support GPs better. By the time a GP seeks help for burnout – and Pulse has published figures that show that one in ten GPs every year do – it is too late.
Just one partner off work due to stress places a huge burden on a small practice and will have a detrimental effect on patient care. Occupational health can address the symptoms, but not the causes.
GPs cannot continue managing their spiralling workload and taking on more work from secondary care without the necessary resources.
The general practice share of the NHS budget has plummeted to an all-time low of just over 8% – despite 90% of patient contacts in the NHS being carried out by GPs, and against the backdrop of a population increase brought about by a baby boom and a rise in the old and very old. This cannot continue indefinitely.
As a recent RCGP survey showed, 62% of the public believe that the number of patient consultations GPs conduct each day is a threat to the standard of care they can provide to patients.
It is time for an urgent reassessment of how GP practices are funded. In particular, the devaluation of QOF payments, the MPIG withdrawal and the national review of PMS funding should be reconsidered as they are causing massive problems for practices.
The current GP recruitment crisis means that practices are having to wait 12 months in some cases to fill a vacancy, even in leafy English suburbs. This is piling workload onto practices and urgent effort is needed to look at the ‘leaky bucket’ and boost GP retention and returner programmes.
We also urge you to reconsider the restrictions on occupational health funding for practice staff, such as practice nurses or managers. They are vital to the functioning of a GP practice, and they are subject to many of the same pressures as GPs.
As you have said, GPs are the cornerstone of the NHS, providing an essential service to patients, and the future of the NHS rests on them playing an even more active role. But we have reached a tipping point.
Without better support from NHS England, GP practices will struggle to provide the care that patients need. You have indicated your willingness to listen to the profession’s concerns and act, and we ask you to do this again.
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