Health Committee Inquiry into the challenges affecting primary care services: Evidence submission

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Our response to this Inquiry focuses on our insight into the challenges affecting general practice in England, rather than primary care services more broadly, although we also refer to the role community health services will need to play if the vision outlined in the NHS five year forward view is to be achieved.


  • The future of general practice rests on a combination of investment and reform. Investment is needed to reverse the declining share of the NHS budget going into general practice. Reform is needed to address workforce issues and improve services for patients.
  • A lack of robust data about the volume of demand, nature of activity carried out by general practice and quality of the services it provides makes it difficult for us to confidently assess the extent of the pressures on general practice and the standard of care it provides to patients.
  • However, contextual factors lead us to believe that quality is unlikely to have improved since the independent inquiry into the quality of care in general practice commissioned by The King’s Fund in 2011, and in some respects may have declined.
  • Anecdotally there are reports of significant pressures on the GP workforce, with rising demand and increasing commissioning and regulatory responsibilities resulting in difficulties recruiting and retaining GPs. At the same time, the size of the GP workforce has not kept pace with population growth. These issues must be addressed if general practice is to successfully develop the new models of care outlined in the Forward View.
  • The prize on offer is for general practice to lead the development of integrated out-of-hospital services. This means working in new ways, at scale in federations and networks, to provide a wider range of services and better access for patients and to embrace the opportunities offered by information technology. To encourage this, we have proposed that a new type of contract should be available to GPs.