Joe Tibbetts is the CEO Boilerhouse Media Group and managing editor Healthcare Innovation Monitor. Joe has advised many government, NHS and commercial healthsector organisations on digital communications


What the GPs are telling us about the Future of General Practice

GPs are not happy. According to the latest BMA survey, The Future of General Practice 2015, not only are they not happy, but they are more unhappy than ever before. But contained within the survey are signs that things within general practice are, at last, beginning to change.

The single main cause of GP unhappiness is workload. According to the BMA survey it is the top factor negatively impacting upon a career in general practice, by some considerable distance. 37% of GPs think that their current workload is unmanageable, and an incredible 93% say that their workload has negatively impacted upon the quality of care given to patients.

The workload issue also stands out as something that has changed significantly since the last BMA survey in 2011. For GP partners the number expressing the amount of work related stress they experience as ‘heavy and unmanageable’ has nearly doubled between 2011 and 2015 from just over 10% then to 19% now. Between 2007 and 2011 it had hardly changed. And things feel different now: there is no longer a question of whether there is a crisis in general practice, but more one of what are we going to do about it. Even Jeremy Hunt has promised more GPs!

As a result of this crisis we are seeing some changes. Most obviously, more GPs want to leave or reduce their hours. The percentage intending to retire in the next 5 years has gone up from 26% in 2011 to 34% in 2015. 17% of GPs (and a whopping 35% of GP trainees) now want to move to part time working.

But there is light on the horizon. We are also seeing a move to working with (or getting supported by?) others. In 2011 70% of GPs were ‘completely supportive’ of maintaining independent contractor status, but in 2015 this had fallen to 57%, a level unthinkable 10 years ago. While 56% of GPs still want to work in owner occupied premises, 27% now do not want to work in owner occupied premises. These are startling statistics because GP practices as independent contractors owning their own premises have been the hallmarks of traditional general practice for decades.

43% of GPs (nearly half!) say their practice has joined a federation or network. It is no longer the small minority that of practices that are getting involved with federations or networks. This has been for a host of reasons, the top five of which are:

  • Bidding for and delivering primary care contracts (43%)
  • Providing GPs with more influence over healthcare delivery (40%)
  • Long term security of the practice as part of a larger structure (39%)
  • Bidding for and delivering community based services (32%)
  • Improving patient care (30%)

Joining a federation is not just a defensive manoeuvre to gain extra protection for the status quo. Indeed when asked which of the 5 Year Forward View (5YFV) models would work best locally, over half responded that practices working in federations or networks working more collaboratively with other healthcare professionals (e.g. consultants, nurses) would work best. No other model gained anything like this level of support. And 75% of GPs would like to work in GP premises with access to local primary care hubs providing diagnostics, extended care in the community and out of hospital services.

GPs understand the problems that they face, and clearly recognise that on top of the need for more funding and more GPs, something more fundamental has to change. GPs, it seems, have a clear idea of what they believe can work in the future, and how it needs to look. What the system now must do is get behind the GPs and provide the support they need to get there.

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