Funding for general practice is due to fall by 17% in real terms by 2017/18, while patient consultations are set to rise by 69m, according to new research published today by the Royal College of General Practitioners (RCGP).
The study, conducted by Deloitte, shows that if current trends continue, funding for general practice across the UK will fall to a record low of just 7.29% of the NHS budget by 2017/18 – down from 8.39% in 2012/13.
Meanwhile, the number of patient consultations in England is estimated to rise to a high of 409 million – up from 340m in 2012/13. In 2008/09 the number of consultations stood at nearly 304 million.
The number of consultations in general practice has increased as the population has increased in size, grown older, and more and more people have multiple-conditions. However, the share of funding spent on general practice has been falling since 2005/6.
The new Deloitte report claims funding for general practice will fall from £9.29 billion of the current total NHS budget of £110.9 billion to only £7.7 billion, in today’s money, by 2017/18, a decline of 17.1%. This means that in real terms, general practice will receive £1.59bn less in real terms by 2017/18 than it was in 2012/13.
According to the Deloitte projections, general practice in England could receive just 7.28% of the NHS budget by 2017/18, down from 8.5%. General practice in Scotland could receive just 7.4%, down from 7.78%. Meanwhile, general practice in Wales could receive just 7.52%, down from 7.77%. The RCGP warns that the combined forces of rising demand and diminishing funding will have disastrous consequences for safe patient care.
Around 90% of contacts with patients in the NHS take place within general practice but the percentage share it has received from the four governments of the UK has been in decline for the best part of the last decade. In a recent poll of members of the public, conducted by ComRes, in March, 60% of the public said they thought that some funding should be moved from other parts of the health service into general practice.
Deloitte estimates that even to stand still, general practice would need £11.47 billion – or 9.81% – out of a projected NHS budget of £116.86 billion by 2017/18. The College is asking for 11% of total NHS funding to be pumped into general practice by 2017/18 and has launched its first-ever campaign Put patients first: Back general practice, in conjunction with the National Association of Patient Participation (NAPP).
Dr Maureen Baker, Chair of the RCGP, said: "These projections show just how grim the future looks for the care of our patients in general practice, across the UK. "The current approach to the way we fund general practice makes no economic sense at all - as investment is being cut at the very point that demand is soaring.
"These projections show that funding for general practice is on a simply unsustainable trajectory. "Investment in general practice has already been cut to the bone, and these projections show that by the middle of the next Parliament general practice will be teetering on the brink.
"If general practice is run on a shoestring, waiting lists will inevitably get even longer and standards of patient care will fall.
"Every day, GP surgeries conduct well over 1m consultations, with GPs and practice nurses working flat out to provide good, safe, compassionate care. "Patients should be able to get an appointment with their GP when they need one - and GPs and practice nurses should be able to concentrate on the person in front of them instead of worrying about the queues building up in the waiting room.
"General practice is the cornerstone of the NHS and we cannot sit back and allow it to wither on the vine, as if it were to collapse the rest of the NHS would follow close behind. "By investing properly in general practice, we could secure the future of the entire health service - and would be able to provide the majority of care in the community, therefore preventing unnecessary and expensive admissions to hospital."
President and Chair of the National Association for Patient Participation, Dr Patricia Wilkie agreed, saying: "Patient care is now being compromised. Many of us are waiting a week or more for consultations and there is a critical need for better continuity of care, particularly for the frail elderly and those with complex needs.
"We believe that there needs to be increased investment in patients and GP care in order to improve and sustain the high standards of quality in patient care that patients need and GPs want to give."