GP state of emergency declared by London GP leader

Today 400 doctors and practice staff join Dr Michelle Drage, London’s GP leader, in declaring a “GP state of emergency” in the face of pressures which threaten services to patients.

Speaking at Londonwide LMCs annual conference, Chief Executive Dr Drage shows a red card to the “increased pressures that dis-incentivise people from joining the profession and are causing people to leave in their droves.”

“Patients risk losing their GPs unless pressures on general practice are dramatically eased. General practice is at breaking point. That’s not safe for patients or staff. Between bean counting, over inspection and rising indemnity fees London general practice has had enough. We’re declaring a GP state of emergency.

“Unless GPs push back against non-core demand and focus on what’s immediately necessary for care, there’s a real risk that we’re not only letting down ourselves, but also our patients.

“We’re focusing on this state of emergency among our  workforce because a year ago we committed to doing six-monthly workforce surveys of London GP practices and the results have been worrying. November’s survey shows that almost half of practices are short at least one member of staff; a third are missing at least one GP and 39 practices are considering handing back the keys within three years.” says Dr Drage.

To address this state of emergency Londonwide LMCs are working with national GP bodies such as the BMA’s General Practitioners Committee and the Royal College of General Practice to promote unity amongst the profession and ensure that the voice of London GPs is heard on the national stage. Supporting individual practices through these challenging times, Londonwide LMCs have produced a number of documents to try and help practices improve their internal systems to enable better cash flow management, the ability to safely decline inappropriate work, and freeing up more appointments via alternative prescribing etc.

Background

Patient numbers are up

• The population of London reached 8.6m in 2015 and is expected to continue to increase to over 10m over the next 15 years.
• London’s population is ageing with more chronic disease managed in general practice. 
• There has been a steady rise in the average number of consultations per patient from 3.9 in 1995 to 8.3 in 2015.

Doctor numbers are down

• 16% of London GPs were over 60 years old, when compared with 10% nationally in 2011.
• On average London has approximately 60 whole time equivalent GPs per 100,000 patients.
• Londonwide LMCs survey of practices showed that out of the 644 responding practices, 284 report a GP planning on retiring in the next three years and 199 of the 644 responding practices currently have a GP vacancy. 
• Despite the government pledge of 5,000 more GPs, the National Recruitment Office reported that nationally rearly 20% of GP training places remained unfilled in 2015. 
• London did not have any vacant posts in 2015 but there was a decrease in applicants to London training schemes as per the rest of the country. 
• London is a net exporter of GPs, with a significant number of doctors leaving the capital once they have completed training as GPs.

GP funding is down

• Funding to general practice has been decreasing in recent years.  Recently there were government announcements of an increase in NHS funding  from £116.4billion in 2015/16 to £133.1billion in 2020/21. This amounts to a real increase of £4.5billion.  However most of this increase will be absorbed by inflation leaving a real average annual increase of 0.9%. 
• Current health expenditure in the UK was 8.46 per cent of GDP in 2013. This compares to 16.43 per cent in the USA, 11.12 per cent in the Netherlands, 10.98 per cent in Germany, 10.95 per cent in France, 10.40 per cent in Denmark, 10.16 per cent in Canada and 8.77 per cent in Italy. 
• Between 2009/10 and 20013/14 funding for general practice fell by an average annual rate of 1.3% in real terms, in comparison funding for hospital services increased at a rate of 2.0% in real terms.  As a percentage of overall NHS funding, general practice funding has fallen from 10.33% in 2004/5 to  7.8% in 2014/15
• Over the past decade, costs of running practices has risen 2.3% and GP earnings have fallen by 16%.

Notes to editors

1. For further information please contact Alex Orton, Londonwide LMCs Media Manager: 020 3818 6239 / 07768 139 704 / alex.orton@lmc.org.uk.
2. Londonwide LMCs is the only independent body in London representing over 7000 full and part-time GPs and over 1300 practice teams across London.
3. Local medical committees are the statutory body representing GPs and practices; 27 London boroughs have a local medical committee, supported by Medical Directors working for the umbrella organisation (Londonwide LMCs) covering NW, NCE and South London.