RCGP General Election manifesto

The RCGP General Election manifesto for England sets out seven steps to save general practice and safeguard our NHS.

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Headshot of Professor Kamila Hawthorne from the shoulders up, smiling and head is slightly tilted to the right.

Foreword from Professor Kamila Hawthorne

Chair, Royal College of General Practitioners

General practice is the cornerstone of the NHS, providing care to around 1 million patients every day. Last year, general practice carried out a record 340 million appointments in England. It is the first port of call for most people when they need medical help. Without general practice, the rest of the health service would be overwhelmed, and the NHS simply would not exist as we know it.

But general practice is in crisis. Despite growing patient needs, the size of the GP workforce is shrinking, and general practice buildings and equipment are not fit to deliver 21st-century care due to lack of investment. The Government has failed to meet its target of an additional 6,000 GPs, and in fact, we have at least 950 fewer full-time equivalent GPs in England than in 2019. We are losing GPs faster than we can train them, with over a third of GPs saying they plan to quit in next five years. This would result in an overwhelmed NHS, with longer waiting times, reduced continuity of care and putting patient safety at risk.

As consultants in general practice, GPs have distinct expertise and experience in providing whole person medical care, whilst managing the complexity, uncertainty and risk associated with the continuous care they provide. GPs work at the heart of their communities, striving to provide comprehensive and equitable care for everyone, taking into account their health care needs, stage of life and background. We work in, connect with and lead multidisciplinary teams that care for people and their families, aiming to ensure all of their physical and mental health needs are met. But to fully achieve all of this, GPs need the time, workforce, and resources.

Investing in primary care leads to better health outcomes and delivers value to the NHS, the economy and society as a whole. The NHS Confederation has calculated that for every £1 invested in needy areas of primary care, at least £14 is delivered in productivity across the working community. Yet the proportion of NHS investment in general practice has fallen and funding is even less in deprived areas once patient needs are taken into account.

That’s why it is critical that all political parties make improving access to general practice and patient care a top priority in their manifestos ahead of the next general election.

RCGP general election manifesto (PDF file, 1.3 MB)

Seven steps to save general practice and safeguard our NHS

1. Protect patient safety by introducing a national alert system to flag unsafe levels of workload and allow practices to access additional support

Every Integrated Care System (ICS) should be required to establish alert systems for general practice, similar to the ‘Operational Pressures Escalation Levels Framework’ in hospitals. As part of this, there needs to be a nationally agreed framework setting out how ICSs can support practices so that patient safety is protected as much as possible.

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2. Ensure patients get the care they need, closer to home, by increasing the share of NHS funding for general practice

Despite moves to shift patient care out of hospitals and into the community, there has not been a sufficient transfer of NHS funding to general practice. General practice urgently needs greater investment to enable more patients to be seen within their communities, to prevent ill health and reduce the need for patients to go to hospital.

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3. Provide more support to patients in deprived communities

Practices in areas with the poorest communities have on average 14.4% more patients per fully qualified GP than practices in wealthy areas, and they receive 7% less funding to cope with the additional needs of their local populations. As funding for general practice is increased, all funding streams should be reviewed to channel more spending to the areas of greatest need.

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4. Ensure every patient who needs to see a GP can do so quickly and safely by taking action to grow the GP workforce

NHS England has estimated that we need 12,000 more GPs by 2031/32 to meet patient needs. To achieve this, we need clear actions to recruit more trainee GPs and do more to keep GPs in the workforce for longer, which should include:

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  • A new nationally funded ‘one-stop-shop’ retention programme. This must be backed by sufficient resources to offer tailored support to GPs at all stages of their careers, including fully funded protected learning time. As part of this, new to practice fellowships must be made more easily accessible for all newly qualified GPs to support them to develop fulfilling and sustainable careers.
  • Investment in training capacity in general practice. The Long-Term Workforce Plan aims to expand the number of GP training places by 50% by 2031 and increase the training time doctors spend in general practice, but 73% of general practice staff say they have little or no capacity to increase training places. Concerted action is needed to train more trainers, offer more support to existing trainers, and to expand the physical space for training placements in general practice.

5. Give every patient access to a modern fit for purpose general practice building, by investing at least £2 billion in infrastructure

GP premises also need the space and resources to accommodate expanding primary care staff teams, utilise advances in technology, and to deliver on the NHS’s sustainability commitments and the path to net zero. In addition, new community health centres are required to support the co-location and integration of general practice with new community services, such as wellbeing services, diagnostic hubs and social prescribing, to enable patients to access the support they need more easily within their local neighbourhood.

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6. Free up GPs to spend more time with patients

Our members estimate they spend a third of their time on unnecessary workload and bureaucracy. To allow GPs to spend more time focusing on patients and deliver more continuity of care, we need to reduce top-down contractual requirements and bureaucracy and prevent the inappropriate transfer of workload from the rest of the health system into general practice.

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7. Guarantee permanent residence for international medical graduates qualifying as GPs to make sure they can work in the NHS

International doctors now make up about 46% of our GP trainee workforce. They must be guaranteed permanent residence in the UK on qualifying rather than having to extend their Tier 2 visas. We otherwise risk making working as a GP in the UK a less attractive option and losing the benefit of the investment that has been put into their training.

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Investment in general practice is an investment in the entire NHS.

We call on all political parties to support and strengthen general practice so that our patients receive the care they need and deserve, now and in the future.