Written evidence submitted by Branston and Heighington Family Practice, Lincoln (FGP0106)

We are a small semi-rural practice with a sole GP Principal who employs 3 salaried GPs, 2 Advanced Nurse Practitioners and other staff. We have approximately 5600 patients. We are responding to this parliamentary enquiry as we wish to General practice to thrive and continue.

The main barriers to accessing General Practice are:

  1. Insufficient General Practitioners – train, recruit and retain GPs. Supporting staff help but experienced GPs are gradually dwindling.
  2. Not enough GP partners. Make partnerships more attractive by decreasing workload and understanding that there are no “part-time GPs”. 3 days a week is 36hrs + as GPs work longer days and do admin on days they are not working. Partners should be earning more than salaried GPs who should be earning more than locum GPs. At present it is the other way round so there is no incentive for GPs to become salaried and then partners. Also locum GPs work less hours and have less responsibility but are earning more.

The Government and NHS plan to improve access does not work, as they only provide money to increase face to face consultations. There is insufficient staff to see more patients and seeing more patients face to face decreases access as this takes more time and clinics get booked up with problems that could be dealt quicker online or by being dealt with by a different member of staff. There needs to be a variety of ways patients can access General Practice – online, telephone and face to face according to need rather than preference as this is more efficient.

For elderly and complex patients, seeing the same GP/clinician is essential to continuity of care. For younger patients – working and parents of young children – access online or by telephone is more helpful for them to access healthcare and it is not so crucial to see the same clinician for acute problems.

The main challenges for General Practice in the next 5 years is the growing cohort of elderly patients with many conditions needing complex care.

Rural areas need more local services as there are long distances to services in the cities.

General Practice is a vital part of the “Prevent Agenda”

To increase General Practice morale and stop burnout:

  1. Explain to the public that GP salary is used to run practices – pay for staff etc so GP earnings do not represent the take-home pay.
  2. More money for estates - Estates Plan for Primary Care just like they have for secondary care that will help fund improvements to existing Buildings or help provide funding for new projects. It is of little point getting more people into Primary Care to cope with the demand if the very fabric of the building is collapsing.
  3. Reduce bureaucracy – allow ANPs to sign sick notes, allow specialities to refer directly to other specialities without needing to go through a GP. A copy can be sent to the GP for the patient’s records.
  4. Make funding recurrent rather than one off pots of money. Many good initiatives have been lost due to no recurrent funding e.g. complex care nurses, primary care navigators, admiral nurses (dementia care support)
  5. Value General Practice – as clinicians we can decide whether a patient needs to be seen face to face or can be managed remotely. Let us treat patients according to need rather than arbitrary demands.
  6. Give funding for admin support for PCNs who now have to employ staff.
  7. Stop extended/enhanced access and put the funds into core hours so that we can provide quality care for patients in-hours – we already work before and after the normal “9-5” day and there is out of hours provision for emergency care.

Dec 2021