General practice must be given a funding uplift in 2025/26 that allows it to hire more GPs if the NHS has any hope of avoiding another winter crisis next year, health leaders have warned in a new joint proposal.
This must be followed by an increased share of NHS funding for general practice to match the increased workload involved in moving more care into the community, the proposal urgent and emergency care concluded.
More funding should also be channelled to areas of greatest need to better support patients in deprived communities, it said.
This year the NHS ‘got the winter it prepared for’, the joint proposal from six organisations, including the National Association of Primary Care, the RCGP, Patients Association and the Royal College of Emergency Medicine, said.
Poor standards of care are being ‘normalised and accepted as inevitable’ as a winter crisis becomes expected, they added.
A key part of preparedness planning must involve boosting primary care capacity, which should also include freeing up GPs from bureaucracy to have more time to spend with patients, the proposals said.
And a national alert system should be put in place to flag when practices are facing ‘unsafe levels of workload’ with extra support available from ICSs, similar to the OPEL system in hospitals.
In addition, the report recommended:
- All older people in a high-risk group should have a ‘full health MOT’ every year, that takes into account loneliness and isolation risks. To be done by integrated neighbourhood health teams with input from primary, community and mental health.
- Community services should be better aligned to each PCN to make better use of existing resources and focus on prevention.
- Paramedics should be used to support primary care with home visiting and face to face services.
- Everyone in a care home should have the NHS delivered to them with GPs and community teams being the first point of contact rather than 999.
- More investment to identify the highest users of urgent and emergency services and get a care plan in place.
- Consider making the flu vaccination available, subject to JCVI approval, to a much broader group than currently defined.
- Improve the flow in hospitals by beginning to resolve bottlenecks from delayed discharges.
- Creating a single 24/7 service focused on caring for people in their normal place of residence that brings together the current urgent community response teams, virtual ward teams and emergency department.
RCGP chair Professor Kamila Hawthorne said winter pressures were being felt intensely, right across the health service with general practice no exception.
‘When general practice is properly resourced, our service can alleviate pressure across the whole of the NHS and provide cost effective care closer to home, where patients want it.
‘With the right time and support we can work with patients to prevent health conditions reaching the point where emergency care is needed.’
She said the RCGP supported the Government’s aspirations to shift more care into the community but it had to be resourced.
‘We need to see the funding uplift for general practice for 2025/26, which has been promised, being delivered and used to build the GP workforce – and we need this to be sustained in future years.’
If the recommendations are not put in place, the ‘unsustainable cycle of seasonal pressures will continue and intensify’, she added.
An NHS spokesperson said: ‘We know this has been one of the toughest winters ever for NHS staff and patients, with record demand for care, worrying levels of flu and other winter viruses and high bed occupancy in hospitals.
‘We agree with many of these proposals to help improve care, which is precisely why, in preparing for this winter, we have focused on providing more care in the community and integrating urgent and emergency care services, alongside primary care, as well as making the most of tools like same day emergency care and care transfer hubs to boost patient flow.’
A new urgent and emergency care improvement plan will be published soon they added.
A Department of Health and Social Care spokesperson said: ‘The NHS is enduring an incredibly difficult winter, but we have ensured A&Es are strike free for the first time in three years, introduced the new RSV vaccine, delivered 27.9 million Covid and flu vaccinations over winter and put immediate extra investment into the NHS.
‘However, we have been clear that the recurring winter crisis should no longer be the norm. That is why this government is committed to delivering comprehensive reforms to transform urgent care and ensure the NHS is fit for the future.’
Recent weeks have seen a significant rise flu, norovirus and RSV in the NHS, with multiple hospitals having declared critical incidents due to high volumes of patients being admitted.
A version of this article was first published on our sister title Pulse.
