Shining a light: general practice under pressure

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The issue

General practice has been under growing pressure in recent years. GPs are facing an increase in the volume and intensity of their work, while large numbers are retiring and leaving the profession and patients are finding it more difficult to access appointments. This has led to a feeling of crisis but understanding the reasons behind this was hampered by a systemic lack of data and analysis.

What did we do?

To form a clearer picture of what was happening, we undertook a major research project leading to our May 2016 publication, Understanding pressures in general practice. This combined more than 60 interviews with practice staff, a workload survey of 50 practices and a survey of more than 300 GPs in training, with new data on activity in general practice, sourced through an agreement with one of our corporate supporter, TPP. This enabled us to analyse 30 million patient contacts from 177 practices, making the report the most comprehensive assessment of the pressures on general practice published to date.

The report was the Fund’s first major publication on general practice since 2011. We are building on it by researching new models for delivering GP services that could alleviate the pressure on practices and improve services for patients. This work is exploring a range of different service models from the UK and abroad and will culminate in a report to be published in June 2018. We are continuing to monitor the pressures on general practice through our ongoing data agreement with TPP.

What was the impact?

Our report generated widespread coverage in the media. It remains the most comprehensive assessment of demand and activity in general practice and has played an important role in building understanding of the ‘crisis’ in general practice.

The report led to extensive engagement with national policy-makers. This included helping the Cabinet Office design its work programme on primary care; membership of NHS England’s oversight group on a new GP contract; working with NHS England as it develops the revised GP patient survey. We have also supported NHS England and the Department of Health and Social Care to develop processes for monitoring workload in general practice.