Source: Practice Index
The British Medical Association’s General Practitioners Committee (GPC) has outlined a vision to address the ongoing crisis in general practice. Their Patients First proposal seeks immediate reforms to prevent practice closures, to secure more funding, and to reshape GP contracts to ensure long-term sustainability. Currently, general practice receives £112.50 per patient per year, but the BMA is advocating for this to rise to £152.50 by 2025.
Central to the BMA’s vision is an increase in financial investment to help tackle workforce shortages and relieve pressure on GP practices. The proposal to raise funding is aimed at attracting and retaining more GPs, as well as bolstering support staff, which would ultimately improve patient care and reduce hospital admissions.
Amongst a wide range of recommendations, which can be viewed here, the BMA puts patient safety first by aiming for a gold standard of 1 FTE GP per 1,000 patients by 2040 alongside a safe number of 25 appointments per GP per day.
The BMA also emphasises the importance of continuity in GP services, which they believe could have a significant impact on reducing hospital admissions and improving patient outcomes. The plan includes redesigning GP contracts to better reflect the demands on staff and adequately compensate GPs and other practice members.
What Practice Managers think
For Practice Managers, the idea of more funding represents a potential lifeline. More funding could help ease the financial strain many practices are experiencing. It would allow for the recruitment of much-needed staff, both clinical and administrative, which would go a long way to reducing the overwhelming workloads currently faced by many teams.
One Manager from a small rural practice remarked: “I probably sound like a broken record, but we’re stretched to the limit. We’ve had to turn patients away because we just don’t have the capacity and we can’t afford to recruit, even if there were GPs willing to come out into the sticks and join our team! The 1,000 patients per GP seems a long way away from reality!
“We’ve also picked the low-hanging fruit and then some, and because we’re small, we just can’t squeeze any more economies of scale. If this funding comes through, we’d be able to offer more appointments, take on more locums, and hopefully provide the care we’re supposed to. Of course I welcome the recommendations, but seeing is believing when it comes to meaningful change or uplifts in funding.”
Other Practice Managers we spoke to were generally in favour of the recommendations, which they felt did address the bigger issues facing practices. There was also widespread praise for the call to alter the Additional Roles Reimbursement Scheme (ARRS) to allow practices ring-fenced funding for Practice Nurses which would help practices employ more of the roles they need.
However, there is also a healthy level of scepticism about whether the government will deliver on these promises. The funding increases depend on government support, and some practice leaders fear the reforms will either be delayed or watered down.
A manager from a large city practice voiced some concerns: “We’ve heard this all before. The BMA, or whoever make these grand proposals, and it usually goes nowhere. By the time the money arrives, if it does, it’s nowhere near what we need. We’re losing staff constantly, across the practice, not just at GP or Partner level, and I don’t see that improving overnight.”
Possible benefits
Despite some reservations, there is a sense of cautious optimism. One Practice Manager told us: “Even small increases in funding could help us better plan for the future and the hope is that a more stable financial footing will enable us managers to think long-term, rather than just trying to keep the lights on.”
Another Practice Manager added: “The BMA’s proposals to retain experienced GPs could make a real difference to practice stability. I’m not alone in saying that the ongoing exodus of senior doctors and practice team members has had a damaging effect on both patient care and staff morale across our practice. Keeping those experienced team members in practice could be a huge boost. We lost two senior GPs last year and the rest of the team has really struggled to cope. If these changes mean we can hang on to those experienced hands, it would be a real game-changer for us.”
Concerns and risks
However, not all managers are convinced that the changes will go as smoothly as the BMA hopes. The complexities of negotiating GP contracts with the NHS and the government could mean that any significant reforms will be delayed or tangled in red tape. The worry is that PMs may end up having to navigate more bureaucracy, rather than seeing the improvements they were promised.
There’s also a risk that, if the proposed funding increase isn’t sufficient or fails to materialise, practices could find themselves expanding their services in anticipation of money that doesn’t arrive. This would leave them even more financially vulnerable.
One sceptical Practice Manager said, “If they think a few extra pennies a day per patient is going to solve the problem, they’re kidding themselves.”
The BMA’s vision offers a possible route out of the crisis facing general practice. For Practice Managers, the idea of increased funding and support provides a glimmer of hope. However, with many feeling let down by similar promises in the past, there is a level of wariness about whether these reforms will truly deliver.
“We’ve learned to take these things with a pinch of salt,” one manager summarised. “We’ll wait and see what happens, but we’re not holding our breath.”
Ultimately, Practice Managers will continue to do what they always do, managing in difficult circumstances while hoping for positive change.
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