Driving change in general practice: The power of unity

In the labyrinthine structure of healthcare administration, the multitude of general practitioner (GP) practices—over 6,500—has long been a subject of debate. Initiatives like Primary Care Networks (PCNs) aimed to streamline this complexity, but the reality presents a more nuanced scenario

CREDIT: This is an edited version of an article that originally appeared on Ockham Healthcare 

Contrary to common belief, managing general practice doesn’t entail negotiating with each of the 6,500 practices individually. Instead, a single contract governs them collectively, streamlining the process and enhancing efficiency compared to the multitude of local negotiations with provider trusts.

Absorbing costs: The strain on practitioners

Despite operating without returning a deficit, general practice finds itself in a unique predicament. While the wider National Health Service (NHS) grapples with an annual debt burden of £1.5bn, general practice absorbs its own costs, often at the expense of practitioner well-being. Despite facing successive years of funding cuts, the workload in general practice continues to rise unabated.

Challenges in funding

The recent response from the system—a proposed 1.9% increase in the core contract—falls well short of inflation rates, further straining an already stretched system. Local commissioners wouldn’t dare offer such meagre increments to hospital trusts due to the potential backlash. Yet, NHS England seems to believe it can impose such terms on general practice without significant repercussions.

Strengthening collective voices

But why is general practice perceived as a soft target? Is it the fragmented nature of practices, making it challenging to quantify their individual impact? Or perhaps, it’s the belief that the pain caused by junior doctor and consultant strikes outweighs any likely repercussions from GPs?

Harnessing collective power: Advocating for change

In response to criticisms of its failure to invest adequately in general practice, the government often points to an overall increase in NHS investment. However, the magnitude of overspending renders additional funding unfeasible for all, leading to general practice being identified as an area for tightening expenditure.

Solidarity in action

To combat this trend, general practice must stand united. While the voice of individual practices may seem diluted, collective unity holds significant power. Bodies like the General Practitioners Committee (GPC) provide a platform for practices to leverage collective bargaining power and demand fair treatment.

The system’s inclination towards local negotiations underscores the latent power of a unified national front. Practices must unite under organisations like the British Medical Association (BMA) to bolster their negotiating stance and affirm that general practice is not an easy target for cuts.

Amidst financial challenges and systemic biases, it’s imperative for general practice to stand together. Through collective action and unwavering support for representative bodies, practitioners can assert their value and safeguard the future of primary care.