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Dr Steve Taylor Profile picture
@DrSteveTaylor
Nov 7, 2022 • 8 tweets • 4 min read • Read on X
Scrolly
GP is changing because the needs of community care have changed over the past 30 years
So in addition to Practice Nurses & GPs there are many other clinicians in the team
Thread 🧵👇🏻
1.4million people a day consult a GP practice
Demand has increased (120% compared with 2019) but GP numbers have fallen (1800 fewer since 2015)
In order to manage demand additional systems have been needed as well as using different methods to consult, & additional clinicians 2/
With 7m awaiting hospital treatment, 10m awaiting follow-up appts, an additional 500k are on long term sick leave since 2019
In addition advances in medical care mean many more are on medications, & have regular reviews of care
People live longer, population has increased
3/
There have been many reasons why GP surgeries are struggling
Many negative comments
A lot of misinformation
But there are reasons for #GPCrisis
4/
There is a lot more work being done in community care
And demand is rising
5/
The GP workforce is ageing
The Government has failed to address the issues of retention
Pension Tax
No income increase since 2005
Increased workload & bureaucracy
6/
We have to accept that funding across the NHS is not enough but the lack of investment in Primary Care leads inevitably to all the other parts struggling
10% of NHS budget spend on Primary Care
7/
An overview of the NHS shows all parts are struggling
Investment is needed in most areas
I would argue that General Practice is outperforming with 10% of the budget (£8bn)
Given sufficient it would help solve the current crisis
8/

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More from @DrSteveTaylor

Dr Steve Taylor Profile picture
Apr 12
1500 more GPs added to the workforce or have they?
@wesstreeting
The headline this week was 1500 more GPs have been added to the workforce since the change in the rules around recruitment of GPs in the Additional Roles Reimbursement Scheme (ARRS) allowed GPs to be recruited. Image
But behind the headlines there isn’t as much to be happy about. I am continuing to hear of GPs unable to get work, or work the number of sessions that they would like . GP unemployment and underemployment hasn’t gone away, despite patients needing GPs. Image
GPs restricted to those who have qualified within the past 2 years, barring a huge proportion of the GP workforce who are struggling to get work.

The ARRS roles themselves are often less well paid, less defined, often split between practices the best for a newly qualified GP. Image
Read 10 tweets
Dr Steve Taylor Profile picture
Jul 15, 2024
GP Core funding is just £107.57/patient/year
@BMA_GP
@DAUK_GP has until now been using the average total figure £165 which includes premises payments, prescribing income & payments for QOF, which are not part of the core contract
Either way it’s not enough
digital.nhs.uk/data-and-infor…
Image
There are huge variations in the income receive per practice with even the average £165 hiding differences in dispensing practices vs non-dispensing

So focusing on £107.57 core GP funding reflects more closely what practices get to employ the staff to provide care for patients Image
The payments received from NHSE are increasingly linked to targeted or non-recurring payments, rather than core contract, making budgeting harder for practices

They’re used to provide all the services provided by a GP practice

An example of an average practice using £165 income Image
Read 7 tweets
Dr Steve Taylor Profile picture
Jun 16, 2024
Richard Meddings - Chair of NHS England ‘Doctors are over-qualified’
Asked if it should be possible to train a doctor in less than 7 years
‘I would have thought so. Or you go to physician associates – so you change the skill levels’

NHS England Board has Post Office Board ‘vibe’ Image
dailymail.co.uk/health/article…
Sajid Javid made Richard Meddings the chair of NHS England 2022
‘brings to the role a wealth of experience’, including ‘years of management in the financial services industry’, giving him a mandate to ‘change and reform’ the health service

Credit Suisse🫣
tribunemag.co.uk/2023/03/the-nh…
Read 4 tweets
Dr Steve Taylor Profile picture
May 13, 2024
NHS vs Private providers

With less than 15% of NHS work done by Private providers, the ‘easy’ stuff, they aren’t going to be the solution to backlogs

Govt/Labour have continued to listen to their leaders

There are solutions which require listening to those who understand Image
Just 24,000 a month self pay compared to 1.4million using the NHS Hospitals
The reality is that the independent sector is benefiting from NHS waiting lists so will continue to be vocal in creating solutions
Read 5 tweets
Dr Steve Taylor Profile picture
Apr 21, 2024
Whopping Whippet stories from the Tories and Victoria Atkins

A thread of mistruths
Nurses 🤔
GP appointments
50m extra but not with an actual GP (Doctor)
Read 9 tweets
Dr Steve Taylor Profile picture
Apr 3, 2024
GP Partnerships - Time for a salaried service?
I keep hearing politicians say that GPs don’t want to be Partners & want to to be Salaried

Well that’s a self fulfilling prophecy since they are the ones deciding funding
Remove the funding for a business & who would want to do it Image
So wants behind this assumption

Firstly there has been a fall in GP Partners & rise in Salaried GPs
The headcount numbers look overwhelming Image
But if you strip away the numbers to Full-Time equivalent GPs
The picture gets less clear in terms of a movement to salaried GPs from Partners Image
Read 8 tweets

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