An ‘explosion’ of 1m more people will be living with more than one serious long-term, life-threatening condition by 2025 – costing general practice in the NHS up to £1.2bn a year, according to new analysis by the Royal College of General Practitioners.
The College forecasts that if current trends continue, it will be 65 years before the share of the NHS budget for general practice – where the majority of patients are cared for – creeps back to the levels of a decade ago, when multi-morbidities such as cancer and diabetes were nowhere near as prevalent.
Addressing 2000 delegates at today’s conference, Chair Dr Maureen Baker will highlight a paradoxical situation where delivering complex care to patients with chronic conditions is most cost-effective in general practice – yet the bulk of NHS money continues to go into hospital care.
Allowing the funding for general practice to decrease to such dangerous levels, she will claim, is ‘throwing money down the drain’.
Currently 90% NHS patient contacts are made in general practice – yet the share of the NHS budget that general practice received stands at 8.33% (England – 8.45%), and the GP workforce over the last five years has remained relatively stagnant.
Dr Baker, will draw on her experience of growing up in a working class family in Wishaw, Lanarkshire, and her own family’s experience of serious illness to highlight how patients’ needs have changed – and how investing in general practice is the only way to cope with this ‘explosion of multi-morbidity’.
She will recount how her father, one of 10 children, died in his 50s and the lives of her uncles and aunts were shortened by heart disease, cancer and respiratory disease.
Today, largely due to the work that is going on in general practice, she will claim that their prognosis would be very different,
“They might be living into their 70s, 80s, and beyond, and would almost certainly be coping with one, two, three or more long-term conditions,” she will say.
“It is a great testament to modern medicine that nowadays we are much more likely to prevent or treat diseases that in the past killed people so early in their lives. GPs have played a pivotal role in this transformation.
“But this success has brought with it a whole new set of challenges to which the NHS is currently struggling to respond.”
Dr Baker will continue: “We need an NHS that’s properly set up to meet the complex clinical needs of people in the 21st century.
“We need an NHS that can achieve this in a cost-effective way, supporting people to stay out of hospital and live as independently as possible.
“And we need an NHS that is caring and person-centred, because we know that clinical need so often overlaps with psychological and social factors.
“We all know what this is – it’s called general practice!”
GPs and practice teams make 370m patient consultations a year – 60m more than just five years ago – indicative of the UK’s growing and ageing population and the sharp rise in patients presenting with multiple, long term conditions.
Dr Baker will renew the College’s call for a ‘new deal’ and a ‘real deal’ for general practice in future.
She will dismiss the English Government’s preoccupation with seven day working as ‘living in cloud cuckoo land’ and a ‘recipe for disaster’ with current resources.
“Mr Hunt you say ‘new deal’, but my message to you and Mr Cameron is this… If you don’t shore up existing GP care as your top priority, not only will you not get a seven day service, but you won’t have a five day service either – because you will have completely decimated general practice.”
Dr Baker will make five demands that have the potential to put general practice on a secure footing for patients and GPs – and restore it to the exciting and stimulating career option that it once was:
More resources – calling on Chancellor in England George Osborne to announce a costed plan to ensure general practice receives 11% of the overall NHS budget, including ‘an immediate injection of £750m of additional core funding in the next financial year.
More GPs – specifically for measures to be taken to stop the ‘brain drain’ and pull out every stop to increase the GP workforce, including financial incentives to attract medical students to general practice, and sanctions for medical schools that fail to take robust action to route out bias against general practice.
Less red tape – including an urgent rethink on the bureaucracy involved in Care Quality Commission inspections.
The latest technology and infrastructure – including maximising the use of increasingly mobile and miniature technology in practices.
Freedom to innovate – with a focus on promoting GP-led new models of care.
The RCGP is calling for general practice to receive 11% of the overall NHS budget and 10,000 more GPs across the UK in order to meet the changing needs of the growing and ageing population.
“General practice is the Obi Wan Kenobi of the NHS – our only hope, but this can only be the case with substantial investment in our service and thousands more GPs right across the UK.
“This is the only way we can transform our NHS so that it meets the changing needs of patients.”
RCGP Press office: 020 3188 7574/7575/7581
Out of hours: 0203 188 7659
Notes to editor
The Royal College of General Practitioners is a network of more than 50,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.