Clearly heard the frustrations from some GPs when I posted three weeks ago on where the NHS is up to. New long🧵recognising and celebrating the central role that GPs and their teams play in the NHS in England. And some perspectives on the frustrations that I heard. 1/x.
GPs/general practice are vital to the effective functioning of the NHS. They’re a key first point of contact to diagnose whether further care is needed and, if so, what care is required. They provide vital continuity of care for patients managing chronic long-term conditions. 2/x
They play a key role in preventive care conducting routine health screenings & vaccinations and identifying/managing risk factors, preventing development of serious diseases. GPs act as key triage point for specialised care, ensuring this care is accessed when most needed...3/x
...Which means holding a lot of clinical risk and making a series of difficult decisions each day. Often at incredible pace, with incomplete information & when those decisions significantly impact patients. A complexity of task that is under-recognised & under-appreciated. 4/x
GPs play a key role in identifying and meeting the collective health needs of their local community. They drive key public health initiatives and collaborate with other providers and services to improve whole population health and reduce health inequalities. 5/x
They also play an important educational role, offering advice on healthy living, disease prevention and chronic conditions. Enabling patients to take control of their own health and wellbeing and supporting them to make informed, important, decisions about their care. 6/x
Importantly, in undertaking all of these tasks, GPs and their teams adopt a holistic approach. They look not just at patients’ physical symptoms but also at the psychological, social, and environmental factors that impact each patient's overall health and wellbeing. 7/x
As a result, GPs play a unique and vital part in each of our individual lives and in the communities they serve. We'll all have our own stories. Laurie Newborne helped save my life six months after I was born. Jonathan Sheldon and his team at Keats Group practice...8/x
...have supported me through a brush with prostate cancer and with ongoing management of a long term condition. They've always been there for all four of us in my immediate family. We couldn't be more grateful for all the excellent care and support they have provided. 9/x
As with the rest of the NHS, the key underlying strategic challenge is meeting rising demand. The number of people living with major illness is projected to increase by 2.5m (37%) by 2040. Over 85s are the biggest users of NHS and the fastest growing age group...10/x
...Number of over 85s has tripled since 1970s and will double again over next 25 years. Also seeing big increase in number of children needing help with mental health issues. The answer to this demand challenge is to both grow capacity but also transform and work smarter. 11/x.
That’s why the first ever NHS Long Term Workforce Plan looks to increase GP training places by 50% to 6,000 by 2031/32, increasing the number of GP specialty training places to 5,000 a year by 2027/28. The first 500 new places planned to be available from September 2025. 12/x
But to grow capacity to levels, & at speed, required, we also needed to grow wider general practice team. It's not either / or - it's about growing both GPs & the wider team. That’s why we invested in more than 36,000 extra ARRS roles since 2019, including physiotherapists…13/x
… pharmacists, physician associates, mental health practitioners, paramedics, social prescribers & health/wellbeing coaches. These specialists can help patients get much of the care they need, enabling highly skilled GPs to focus on patients who need their expertise most. 14/x.
This recent report from @NHSConfed - - is rightly positive about the benefits these new ARRS roles have brought to patients and general practices alike. It also highlights some important issues to address as the scheme beds in and develops. 15/xnhsconfed.org/publications/a…
I heard some frustrations in responses to my thread three weeks ago around the continued ringfencing of ARRS money. We want to protect the new ARRS staff and the new capacity they bring as they bed into their roles, ensuring there is appropriate funding to pay for them. 16/x
Growing primary care capacity rapidly is also why we have created Pharmacy First - . Patients can now get treatment/medicines from their local pharmacy for seven common conditions, saving an estimated 10 million general practice appointments a year. 17/xengland.nhs.uk/primary-care/p…
I heard some frustrations around Pharmacy First funding going to pharmacy rather than General Practice. Local pharmacies are also under pressure and Pharmacy First supports them. It also gives greater choice to patients and helps decompress general practice. 18/x
I heard some frustration at the current focus on access to general practice. I completely agree that quality and continuity of care are important too. Patients tell us that being able to access general practice appointments when needed is currently their biggest concern. 19/x
That's why we've focussed on improving access as the immediate priority. Hard working practices delivered a record 360 million appointments last year, 57 million more than pre-covid. Last month's data showed 50% were on day of request, 69% within a week & 95% within a month…20/x
Only one in 25 patients waited longer than a month for appointments. A proportion of these are routine appointments appropriately scheduled a month out. Others are because patients want a date that’s convenient for them or want to wait to see a particular doctor or nurse. 21/x
With @NHSEngland support 99%+ of practices will have digital telephony systems by end April. They can now “see” demand patterns, reduce peaks by shifting resource and eliminate engaged tones. Patients can receive automated call backs to avoid losing their place in the queue. 22/x
Three million patients a month now use online routes to contact practices for care, appointments or other help, further reducing demand on phones and the eight o'clock rush. Recognising that there are still too many people who can't access an appointment when they want one. 23/x
Like rest of NHS, GPs/general practice under huge pressure as we recover from covid. Recognising there was a growing gap between demand & NHS capacity, including in general practice, before covid. Important to celebrate vital role GPs & teams play and what is being delivered 24/x
Recognise I've not been able to cover all current issues in the thread. E.G. funding, flexible working, workforce development, changing role of GPs as wider team leaders, PCNs and GP estate/IT infrastructure, to name a few. But welcome feedback to stimulate further debate! 25/x
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