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Introduction

General practice is widely perceived to be in crisis and GPs’ workloads to be unsustainable. Rising demand, changing patterns of work by GPs and a fall in the proportion of funds allocated to general practice in England have fed into this picture1. While public satisfaction with general practice remains high, satisfaction with access is falling and expectations of the public and politicians continue to ratchet up the pressure. The sector can and must reform to meet evolving needs. GP capacity must be freed up.

Health Secretary Jeremy Hunt has already promised a New Deal for General Practice.

“The strategic importance of general practice to the NHS cannot be overstated. Within five years we will be looking after a million more over 70s. The number of people with three or more long term conditions is set to increase by 50% to nearly 3 million by 2018. By 2020 nearly 100,000 more people will need to be cared for at home.

Put simply, if we do not find better, smarter ways to help our growing elderly population remain healthy and independent our hospitals will be overwhelmed – which is why we need effective, strong and expanding general practice more than ever before in the history of the NHS.”

Health Secretary Jeremy Hunt, June 2015

This New Deal addresses:

  • Workforce
  • Infrastructure
  • Access with a 7 day NHS
  • Assessing quality of care
  • Bureaucracy and burnout.

This report was commissioned by NHS England as part of its wider work to deliver the New Deal to strengthen primary care and release capacity to introduce new care models. It summarises a number of pieces of work carried out by the Primary Care Foundation and NHS Alliance on behalf of NHS England during 2014/15.

Broadly, it looks at reducing bureaucracy and shaping demand in general practice in order to make more time for GPs to do what only they can do, and for practice managers to take a greater role in shaping the future. It is unique in that it has quantified current pressures across England in order to prioritise recommendations for action.

Part 1 reports on the evidence we gathered and makes recommendations based on:

  • A survey of general practices to identify where the burden of bureaucracy lies and identify changes in contracting and monitoring that would reduce practice time spent on bureaucracy
  • An audit with GP practices to understand how avoidable consultations with GPs arise and where they could have been better directed
  • Detailed discussions with GPs and practice managers to understand what might work better
  • Consultation with our partners to understand the burden of administration of appointments across the primary and secondary care interface.

Part 2 reports on an exercise gathering ideas and examples of innovative solutions and also makes recommendations.

Part 3 is a series of articles and thought leadership pieces commissioned as part of the evidence gathering process.


www.nuffieldtrust.org.uk/sites/files/nuffield/publication/general_practice_in_crisis_3.pdf