GPs in England should become salaried employees of the NHS, rather than be partners who run their own practices, according to controversial proposals published by a leading think-tank today.
The Institute of Public Policy Research says this move, which would overturn the model of general practice that has been in place since 1948, would enable the NHS to deliver better access to and quality of primary care in the community.
The proposals are set to anger many GPs, who have campaigned for more support for the partnership model of practice.
According to the IPPR, it would also help to address the workforce crisis in general practice and would help to deliver some of the government’s key manifesto promises of: delivering 50 million more GP appointments a year in England; raising GP numbers by the equivalent of 6,000 full-time doctors; and boosting morale among health and care staff through more professional training and supportive management.
Harry Quilter-Pinner, IPPR senior research fellow and report co-author, said: “We are facing a crisis in general practice. Patients can’t get access to the care they need. Staff are overwhelmed by workload pressures and stress.
“Since 1948, GPs have been small, local, private contractors. But this model is no longer working. We need to join up primary, community and mental health care in new ‘Neighbourhood Hubs’ and give patients access to the best care when they need it most. This requires us to finally welcome GPs fully into the NHS family through a new right to direct NHS employment.”
The report comes as new polling from IPPR/Savanta-ComRes polling reveals that across England, 36% of people said they waited more than a week for their most recent GP appointment, compared with 28% in Scotland, while 3% of people – equivalent to 1.7 million across the country – said they were unable to access any suitable appointment last time they tried to book one.
The polling also reveals that patients with long-term health conditions are unable to access important care, with more than 50% not receiving any kind of basic support, which includes education about their condition, a social prescription or a longer appointment.
IPPR analysis also highlights that as more GPs move part-time work means that since 2014, the NHS in England has lost the equivalent of 3,000 full-time family doctors – 7% of the total GP workforce.
The report calls for a new model, Neighbourhood Care Providers (NCPs), which would serve communities of between 50,000-100,000 people and would join up primary, community and mental health care. The NCPs would have longer opening hours, diagnostics and treatment in the community and a wider team of healthcare professionals, such as pharmacists and mental health nurses, to support the GPs.
This model would allow ‘doctors to be doctors’ and focus on patient care rather than managing ‘businesses and buildings’, says the think tank.
Chris Thomas, IPPR research fellow and report co-author, added: “Our approach to general practice hasn’t changed since 1948. Seventy years later, that system is at breaking point. There’s an urgent need for a new deal for general practice. At the heart of this must be better pay, conditions, flexibility and work life balance for hardworking general practitioners. It’s time to let doctors be doctors.”