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GP news: letter from Dr Chaand Nagpaul

Below is from GP news and is a letter from Dr Chaand Nagpaul.

I wanted to share that I recently met health minister Earl Howe and Department of Health officials, together with GPC lead premises negotiator Peter Holden, specifically to discuss GP premises.

There has been no national strategy or dedicated investment in GP premises since the new contract took effect a decade ago. As a result, many premises have remained fossilised while others have suffered attrition without refurbishment - all this despite the exponential rise in the volume and range of our work. GP practices are seeing 40 million more patients per year than five years ago and there is a relentless movement of care out of hospitals, due to earlier discharge, post-operative care and reduced outpatient follow-up, as well as a range of chronic diseases that are now largely managed in GP surgeries.

Many practices are bursting at the seams, unable to deliver our patients' needs. Like many of you, my practice cannot provide additional clinical sessions or in-house services, nor accommodate attached staff or provide undergraduate education, simply because we do not have the physical space.

I explained to Earl Howe that GP premises are the elephant in the room and that the government's aspiration across all four nations for GPs to manage care to an expanding ageing population, together with shifting services out of hospitals, just will not be possible until the physical infrastructure is in place to deliver this. Earl Howe and NHS England officials all seem to agree, but what matters is to urgently translate these words into action. The government believes that delivering care in the community will reduce NHS pressures and hospital expenditure, so rather than seeing developing GP premises as a cost burden I urged ministers to view it as an 'invest to save' strategy - essential to their aim of moving care closer to home.

Please look out for the UK-wide GP premises survey we will be launching shortly to find out more about the current landscape so we can negotiate effectively on your behalf.

Are you due a £5 per head resource?

As I mentioned in my last newsletter, NHS England expects clinical commissioning groups to provide resources of £5 per head to support GP practices in managing and coordinating the care of frail older patients with complex needs, as specified in the Everyone Counts planning guidance (paragraphs 36 and 37) and reiterated in NHS England's Transforming Primary Care guidance, launched last week. This funding is in addition to the unplanned admissions enhanced service, and it is good to see NHS England recognising that providing care to older people requires a wider approach.

Practices are expected to put forward proposals to their CCGs, such as providing additional sessions for patients with long-term conditions, or having dedicated community nurses working across a network of practices to provide enhanced coordinated care to such patients.

We are keen to know if your CCG has offered you this resource, or is planning to do so. If you haven't already done so, please complete our CCG survey so we can represent your interests in our discussions with NHS England.

Dr Chaand Nagpaul
Chair, BMA GPs committee GPC in the media

It's been another busy fortnight for GPC in the media. Last Monday saw the announcement of the pilots for the Prime Minister's Challenge Fund. We responded swiftly with a press release and a BMA blog.

GPC's voice was heard across the national media. I and other BMA representatives featured in the Sunday Telegraph and Independent on Sunday, the Guardian, Financial Times, Daily Mail, Daily Telegraph, Metro and the Independent, which openly questioned the Government's position.

In addition to this, I was featured on BBC Radio 4's Today programme, BBC News and BBC Breakfast, ITV News, LBC Radio, Channel 4 and Channel 5 News, and we appeared on BBC Radio 2 and BBC 5Live. We also had interviews on almost every BBC regional radio station, as well as a number of BBC and ITV regional television outlets.

Last week I appeared on BBC Radio 4's You and Yours, discussing the funding pressures facing general practice (listen from 19:16).

We also continue to lead the agenda on the damage being done to practices by the Government-imposed decision to cut MPIG (minimum practice income guarantee). Following on from our successful media campaign earlier this year, we are now seeing further coverage in the press as our cause has been taken up by national and London regional media.

GPC deputy chair Richard Vautrey and I featured in the Guardian, London Evening Standard (watch this clip), Daily Telegraph and BBC London television news, reiterating that it's not just rural areas that are affected - inner-city practices in the East End of London are also facing closure as a result of the policy.


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