Submission to the Health and Social Care Select Committee inquiry into the future of general practice

The King’s Fund is an independent charitable organisation working to improve health and care in England. Our vision is that the best possible health and care is available to all. We aim to be a catalyst for change and to inspire improvements in health and care by:

• generating and sharing ideas and evidence

• offering rigorous analysis and independent challenge

• bringing people together to discuss, share and learn

• supporting and developing people, teams and organisations

• helping people to make sense of the health and care system.

Summary

The King’s Fund has a longstanding interest in the development and reform of general practice and has been examining how to address pressures in general practice since we published an influential report on this issue in 2016 (Baird et al 2016). Alongside a growing body of research and policy work, we also provide organisational and leadership development support to primary care networks and work with GPs across the health system. Our submission focuses on the main barriers to accessing general practice, and the changes needed to the current model to tackle these and put general practice on a more sustainable footing for the future.

Effective primary care, including general practice, is the bedrock of a high-quality and cost-effective health system but general practice in England is under significant strain. These pressures pre-date the Covid-19 pandemic and reflect wider pressures across the health and care system but have significantly intensified over the past six months (NHS Digital 2021a)

General practice has been facing significant workforce pressures for a number of years with projections suggesting a significant shortfall of GPs over the coming decade, despite the increased numbers of GPs in training and the deployment of additional roles (Beech et al 2019). Burnout and attrition as a consequence of the Covid-19 pandemic are likely to have a heavy impact on the already strained general practice workforce over the next year and exacerbate these issues (House of Commons Health and Social Care Select Committee 2021a).

Despite these challenges the most recent GP Patient Survey results, appointment data and the coronavirus vaccine roll-out show that public satisfaction with GP services has remained high throughout the pandemic, that general practice continues to deliver a very high volume of appointments and is playing a significant role in supporting vaccine roll out (GP Patient Survey 2021; NHS Digital 2021a; NHS England 2021). However, it is clear that pressures have, and continue, to affect patients’ experience of general practice, with the previous GP Patient Survey and British Social Attitudes survey showing satisfaction has been declining in recent years, driven by problems accessing appointments (GP Patient Survey 2019; Robertson et al 2019). General practice has been and remains under unprecedented strain and in need of support.