Written evidence submitted by Altmeyer-Ennis (FGP0023)


What are the main barriers to accessing general practice and how can these be tackled?


To what extent does the Government and NHS England’s plan for improving access for patients and supporting general practice address these barriers?


Not at all. The government have been promising more GPs for the last 10 years but still they don’t materialise. What the government, NHSE and the media have done to general practice when we have worked relentlessly over the past two years is nothing short of criminal.


What are the impacts when patients are unable to access general practice using their preferred method?


Years ago, patients accessed primary care by walking in or ringing up. Post was mailed in and took weeks. At the behest of Matt Hancock, we have done our utmost to offer patients a wide range of options for accessing primary care. So we have gone from 2 modalities of access to the following:



Despite multiple computer systems, we still have a real issue with IT systems not speaking to each other which takes up huge amounts of time.


What role does having a named GP—and being able to see that GP—play in providing patients with the continuity of care they need?


All our patients have a named GP and unless it is a Duty session we try and place patients with their named GP, however continuity becomes more of a challenge as our doctors are frequently exhausted trying to keep up with multiple systems and computer systems which are not fit for purpose.


•What are the main challenges facing general practice in the next 5 years?


GPs retiring and lack of new GPs to take over. Please refer to the gap of 7,000 doctors which the government has known about for years. The NHS is not a political football and should not be. NHSE do their own thing and since this government took over, general practice is increasingly ignored.


•How does regional variation shape the challenges facing general practice in different parts of England, including rural areas?


We are in a rural area and are one of the lucky ones that have been able to recruit up to the number of GPs that we can afford to employ. All communities should be served by a GP Partnership.


•What part should general practice play in the prevention agenda?


General Practice already plays a huge part in prevention however this is not just one organisations role. For Example, not helping the population to understand food and nutrition, perpetuates obesity. This needs to start from how parenting is supported, right through to schools. We already do a huge amount to try and make sure that we provide messages but having run a number of campaigns recently about Covid vaccinations, obesity resource, being advise that you and your practice should F*** Off and that we are C**T is not really very helpful.


•What can be done to reduce bureaucracy and burnout, and improve morale, in general practice?


STOP the Government and NHSE using it as a political football. It is not. We are human beings doing our very best whilst the government has sat back and done nothing of any real benefit to get qualified GPs into the workforce. You may think you are training lots of additional GPs but how many finish their degrees and actually work 6 sessions or more as a GP. A tiny amount. Really look at the numbers and how many sessions they are actually doing a year/two years and five years after they have finished training. You may be surprised.


•How can the current model of general practice be improved to make it more sustainable in the long term? In particular:


Stop the awful centralisation that has happened in the UK and allow Regions more autonomy to organise themselves with local funding and budgets rather than drip feeding. You say about us improving however general practice has only implemented what this government has asked. Our demand is up 41% from 3 years ago.


•Is the traditional partnership model in general practice sustainable given recruitment challenges, the prioritisation of integrated care and the shift towards salaried GP posts?


Yes it is. It is an amazingly creative and proactive model. New to Partnership should be an on-going commitment and not just for GPs. Why did the government renege on there being a place for Practice Managers in the scheme. The PCNs have been put in place to try and weaken the Partnership model – think of a Trojan Horse. Why not truly encourage Partnership rather than what this government has done which is to try and destroy it.


•Do the current contracting and payment systems in general practice encourage proactive, personalised, coordinated and integrated care?


The contracting and payment systems are a complete and utter mess. The centralised PCSE model is just not working. We spend hours chasing payments constantly. Why not give a budget such as a hospital has and leave us to manage the resource. The drip feeding of money we now have is farcical.


•Has the development of Primary Care Networks improved the delivery of proactive, personalised, coordinated and integrated care and reduced the administrative burden on GPs? There have been a few gains with personalised care, but let’s be totally frank, all it has meant is that our rare GPs and not supporting in our PCN 12 new staff – none of whom have worked in primary care before and who all are in training.


•To what extent has general practice been able to work in effective partnerships with other professions within primary care and beyond to free more GP time for patient care?


We do this constantly, but really take a look at what we have been doing over the last few years. Demand is up exponentially, the computer systems given create work, computer systems do not communicate together enough, NHSE sending out comms throughout Covid have increased our workload (not got rid of it), PCSE and funding is a joke. Every single piece of policy that comes out from NHSE, requires a clinical lead. Where do you think we can get these – if we don’t take from our precious GP resource.


Nov 2021