“£110,000 a year… and they still won’t see you”. “Wages hit a difficult to justify £142,000”. “Patients turned away as GPs cream off record wages”. These are just three of the most recent newspaper headlines that have once again added fuel to the fire of negativity surrounding GP practices – despite GP partner income increasing faster than their expenses in 2020/21, for the first time since 2005/06!

As all of us Practice Managers know, there’s a huge disparity between this narrative and the reality of practice life. Communicating this to patients is, of course, tricky at best.

“There’s no doubt that the mainstream media narrative is damaging to GP practices,” one PM told us. “Sensationalist headlines exist to suit the agenda of certain newspapers, but we’re left dealing with the fallout. Earlier this week, we had a patient directly quote an article from a tabloid paper when they couldn’t get an appointment for a few days.

“The negative publicity just isn’t fair. Partners have seen their income drop over the last decade, yet they’ve been expected to shoulder the burden of risk and responsibility that comes with running a practice. When times get hard, they have to deal with it – as we are seeing right now with huge increases in inflation and the rising costs of energy, alongside an NHS staffing crisis that is threatening the very existence of some practices. Yet, this all seems our fault because people don’t get to hear the truth – or don’t want to hear it.”

Keep calm and carry on?

This raises the question of how we communicate the inaccuracies of certain news reporting, with PMs taking different standpoints.

One manager of a West London practice suggested saying nothing and just ignoring the criticism because “some people will just believe what they want to believe”. They added: “We must remember that negative patients are thankfully, in my practice anyway, the minority. Most people, genuinely in need of care, understand the position we’re in and roll with the process.”

Enough is enough

Another PM that we spoke to takes the alternative view that we should be communicating the truth – and as a result is in the process of pulling together a series of ‘fact documents’ that will be published on the practice’s website and social media channels, as well as being printed and handed out to patients.

“We’ve simply had enough of the one-sided storytelling, so we have decided to take matters into our own hands.

“It’s not like we’ve got an endless stream of new GPs banging at our door for work. GP take home is way down in real terms over the last decade, yet that’s not reported, and our income has fallen significantly since we weren’t working seven days a week dealing with Covid. We have to say something to set the record straight and if all practices follow suit with a consistent message, I believe we’ll make a difference. We would love the Institute of General Practice Management or even Practice Index to produce something that could be used nationwide.”

ICB intervention

Talking of collective action, the Leicester, Leicestershire and Rutland (LLR) ICB invited members of the public to share their experiences of GP access challenges at a recent event.

The move came in response to patients believing that ‘access to their GP is not as good as before the pandemic’, according to the ICB.

Speaking before the event, ICB chair David Sissling said: “Primary care is often described as the “front door” of the NHS and most people’s care is through their GP practice, so this is an important topic for people.

“It is important to hear directly from local people about how to improve services and explain how primary care is adapting and responding to the challenges through an open and positive conversation.”

ICB chief medical officer and local GP Dr Nil Sanganee said: “As a practising GP, I know from talking to patients that some believe the service – particularly access to their GP – is not as good as before the pandemic and have questions about how practices are changing and responding to the challenges.”

The figures tell a different story

Interestingly, the negative headlines come at a time when GP practices in England are delivering the highest proportion of face-to-face appointments since March 2020.

As Practice Index reported, NHS Digital’s latest GP appointments data showed that 65% of appointments in GP practices were delivered face to face in July 2022. This compares with 66% in March 2020.

At the same time, further stats from NHS Digital show that the number of fully-qualified full-time equivalent (FTE) GPs continues to fall. There were 27,507 fully-qualified FTE GPs in July, down from 27,558 the previous month and 27,750 in July last year.

“I read that RCGP chair Professor Martin Marshall had said that data showed GPs are doing a ‘remarkable’ but ultimately ‘unsustainable’ job. I couldn’t agree more,” another PM told us. “I’m just fed up with reading negative headlines when I think we’re doing a brilliant job in difficult circumstances and we need to stand up for ourselves by shouting about our challenges and what we do deliver. Maybe we should start posting some stats on our front door showing just how many people we have seen, how many times we’ve received abuse and so on. That might wake a few people up to the real story.”

This PM concludes by saying: “The 11% increase is after a 30% real-terms reduction over 15 years, but it’s nothing more than a temporary blip. We did have an increase in our practice income last year – but this was from all the COVID vaccination clinics that we ran nearly all day every day, including evenings and weekends. The extra money was quite exhausting and not sustainable, however, and we have probably spent it all on locums this year as we can’t get enough GPs.

“In short, general practice is in crisis, but not for the reasons some of the newspapers like to write about.”