'˜Failure' from health officials to spot GP crisis over figures

The lack of nationally available data means that the predicament facing family doctor services has been “largely invisible”, according to health think-tank The King’s Fund.

Had such data been available, the Department of Health and NHS England would have had advance warning of the unprecedented pressures that GP surgeries now find themselves under, the report claims.

“General practice is in crisis,” the authors wrote.

“Workload has increased substantially in recent years and has not been matched by growth in either funding or in workforce.”

NHS England must overcome the deficiencies in data and intelligence “that have allowed the current crisis to develop”, the report states.

The authors wrote: “A lack of nationally available, real-time data means that this crisis has been until recently largely invisible to commissioners and policy-makers. The Department of Health and NHS England have failed over a number of years to collect data that would have provided advance warning of the crisis now facing general practice.”

Beccy Baird, fellow at The King’s Fund and lead author of the report, said: “While we have data almost in real time to tell us what’s going on in A&E, the only national-level data we have on activity in general practice is, at best, a year out of date.

“It wouldn’t be acceptable to try to run a hospital on out-of-date information and it shouldn’t be for general practice either.”

The authors conducted analysis on 30 million patient contacts from 177 practices between 2010/11 and 2014/15.

They found that the number of consultations grew by more than 15 per cent during this period - the number of face-to-face consultations grew by 13 per cent and telephone consultations by 63 per cent. During the same time frame, the GP workforce grew by 4.75 per cent and funding levels dipped from 8.3 per cent of the overall NHS budget to 7.9 per cent.

The authors added: “Pressures on general practice are compounded by the fact that the work is becoming more complex and more intense. This is mainly because of the ageing population, increasing numbers of people with complex conditions, initiatives to move care from hospitals to the community, and rising public expectations. As the pressures on general practice have grown, the experience for patients has deteriorated, albeit from high levels. Our findings point to a service that has traditionally been seen as the jewel in the crown of the NHS coming under growing pressure through a combination of factors.”

The authors suggested a number of strategies that should be employed to “avoid the service falling apart”, including:

:: Accelerating the use of technology to cope with growing demand - such as telephone triage and email consultations where appropriate.

:: Enhancing the workforce, not just through traditional roles, but through new roles such as “health coaches” and volunteers.

:: Reducing the “bureaucratic burden” on practices.

Two weeks ago NHS England announced a package of measures to help get general practice “back on its feet”, including an extra £2.4 billion a year in funding,