PLMR's On The Pulse Newsletter | 4th October 2024

Your weekly round up of the major social care news stories from PLMR 's expert Health and Social Care Team. Nathan Hollow | Lucy Taylor | Jessica Peddie | Michela Bandilla

Doing more with less: GPs pushed to breaking point?

The issue of excessive workloads for UK GPs has reached a tipping point this week, as The Royal College of General Practitioners (RCGP) calls on the Government to alleviate pressures on general practice doctors experiencing “dangerously high workloads” .

The RCGP’s Chair, Professor Kamila Hawthorne, has suggested many GPs are opting to work part-time contracts simply to stay “on top of things” on their days off. Radio 4's More or Less looked into this claim and found GPs are, on average, working half a day less per week than seven years ago. Coupled with the growing demand for primary care services, this news suggests that we have reached a critical moment in primary care.?

How did we get here??

The overall demand for health and care is rising rapidly, driven by an ageing population and an?increased prevalence of chronic illnesses. These changes have intensified the demand for GP services, yet the number of practicing GPs has not kept pace. GP numbers have remained stagnant for several years, despite successive governments promising to bolster recruitment in the sector. According to the British Medical Association, the UK has lost the equivalent of 1,557 general practitioners since 2015 , whilst the number of patients and appointments has continued to rise disproportionally. A single GP is now responsible for an average of 345 more patients than they would have been in 2015 .?

Compounding this issue is the concerted push in recent decades to move more services into community settings, with primary care expected to increasingly embody its ‘front door of the NHS’ role. This precedent is only set to expand, as the government has outlined a renewed push for care in the community as one of the three key pillars of its anticipated 10-year plan for health and care. Currently, less than 10% of NHS funding is allocated to primary care , and this share has been declining over time. Until funding and workforce requirements for primary care are reassessed, any shift into community care will only place further strain on an already buckling system.?

The consequences?

Longer waiting times: For patients, longer waiting times for appointments can mean delays in receiving care, especially for those in deprived areas where GP shortages are more pronounced. This can lead to the exacerbation of health issues and increased reliance on emergency services, adding further strain to the wider system.?

Reduced GP capacity means increasing numbers of people are unable to access early interventions for developing conditions like dementia, meaning many only interact with social care services once circumstances have reached the point of emergency. This leads to further pressures on an already overworked sector and avoidable distress for people in need of care and their loved ones. ?

For GPs themselves, the relentless workload is taking a toll on mental health and job satisfaction. Many are experiencing burnout, leading to early retirement or career changes, further reducing the GP workforce. The problem is self-perpetuating: as more GPs leave, those who remain are forced to shoulder even greater responsibilities, intensifying the cycle of overwork.?

What needs to change??

Addressing the GP workload crisis will require bold change. During a speech at the RCGP’s annual conference this morning, Health Secretary Wes Streeting announced the launch of a Red Tape Challenge aimed at reducing bureaucracy for GPs, and reaffirmed the government’s commitment to recruiting 1,000 GPs by the end of this year. ?

Though this announcement is indicative of some positive progress, meaningful reform must go further, focusing?on areas like better integration with other parts of the system to streamline care delivery and ensuring clearly defined roles and remits for primary care vs. secondary care.?

Without comprehensive?change, the crisis will only deepen, with potentially disastrous consequences for the future of primary care in the UK.?

A ray of hope?

Amongst the continuing health service related gloom, there has been one ray of hope this week. Putting long-talked about digitisation plans into action, Health Secretary Wes Streeting has launched a pilot that will enable women who find a lump in their breast to bypass their GP and book an appointment with a cancer specialist via NHS app . The move could be transformative for patients and paves the way for far greater direct access to specialist consultations on other appoints.

Whilst this could have effect of pushing inappropriate demand onto specialist services, the principle of prioritising the NHS app and making it a larger part of citizen's interactions with the NHS can only be a positive as Labour seeks to make the NHS fit for the future.

What we're reading this week

The Independent : Top GP’s warning over doctors’ ‘dangerously high workloads’?

The Royal College of General Practitioners has called on the government to reduce the mounting pressures being faced by GPs across the country. RCGP Chair, Professor Kamila Hawthorne has suggested many GPs are opting to work part-time contracts in order to manage administrative tasks on their days off and keep up with the job. The sector cites stagnant workforce numbers and increasing demand as two key reasons for growing strain on primary care.?

BBC News : MPs to get first vote on assisted dying for nine years?

Labour MP Kim Leadbeater is putting forward a bill that will change the UK’s legal stance on assisted dying. The bill will propose the legalisation of assisted dying for those living with terminal illnesses who have been given six months to live by their doctor. The bill is expected to be introduced on 16th October, with the debate and initial vote taking place later in the year.?

Sky News : Rising cost of social care and school transport to cause ￡54bn blackhole for councils?

Local councils in England face a ￡54 billion funding gap over the next five years due to rising costs in social care, children's services, and school transport, a report from the County Councils Network (CCN) warns. Even with 3% annual council tax increases, the shortfall would still be ￡38 billion. The CCN says councils will be forced to cut essential services or face bankruptcy, with 16 councils at risk by 2026. It urges the government to provide more funding and reform services to avoid widespread insolvency.?

BBC News : Findlay calls on Swinney to ditch National Care Service plans?

The new Scottish Conservative leader Russell Findlay has called on First Minister to cancel plans for the creation of a National Care Service in Scotland. Findlay accused the government of ‘wasting’ ￡28m on plans for the reform. Scottish Labour leader Anas Sarwar joined the call, suggesting that proposed plans were a ‘disaster’.

Daily Mirror : Women who find a lump in their breast will bypass GP and get cancer appointment via NHS app

Women will now be able to access hospital appointments directly through the NHS app rather than via an initial GP appointment. Health Secretary Wes Streeting made the announcement this morning during a speech at the RCGP annual conference. Pilot use of 111 online to refer patients worried about lumps directly to breast clinics via the NHS app will begin in November to support faster diagnosis and free up more GP appointments.

PLMR Insights Event | In conversation with the BBC's Social Affairs Correspondent, Michael Buchanan

We are delighted to invite you to our upcoming PLMR Insights Event with Michael Buchanan, Social Affairs Correspondent at BBC News. Michael will share his insights on the most pressing social issues in the UK and his experience working at the BBC, which he joined 30 years ago. After a brief introduction, Michael will answer questions in a facilitated Q&A.

Michael has written on a wide range of important topics including social challenges in schools, poor maternity care provided by NHS hospitals, fraud, and housing and homelessness. He has over three decades of experience in journalism and has won numerous awards for his work, including the 2023 Royal Television Society (RTS) Television Journalism Award for Specialist Journalist of the Year for his work on the program Maternity Scandals: Fighting for the Truth.

The hybrid event will be taking place on Tuesday 22nd October from 1.30pm-2:30pm online and at St Ermin’s Hotel (arrivals from 1.15pm). Address: 2 Caxton St, London SW1H 0QW.

To register, please contact [email protected] or message Nathan Hollow on LinkedIn.

Thank you for reading and we hope you have a wonderful weekend!