On 9th September, I travelled to Parliament and met with the Liberal Democrat MPs and their policy writer to share the experiences, concerns, and priorities of our General Practice members.
The conversation was an opportunity to champion the vital role of GPs and their teams, and to emphasise the importance of respect, realistic expectations and recognition of the finite workforce and resources within General Practice. Above all, I shared the passion of our members to do the very best they can for their patients and communities. I described that General Practice teams remain committed to providing excellent care, but they cannot do everything, for everyone, all the time. We need to move away from the current GP contract which focuses on reactive medicine driven by patient demand rather than need. The obsession with acute access continues to fuel demand and expectation at the detriment of continuity of care and the prevention agenda. Uncapped online access pours fuel on the demand fire and threatens safe workload. As Lord Darzi observed in his report for this Government, it is a capacity rather than performance issue for general practice.
Despite Labour’s 10 year plan promise that the share of hospital care will fall, with proportionally greater investment in out of hospital care, the recent Health Foundation report (General practice funding in England | The Health Foundation ) found that general practice share of the budget declined from 8.8% to 8.3% between 2015/16 and 2024/25 while spending on acute services grew from 38.4% to 42.6%.
In 2026/27, the announced value of the GP contract with the subsequent addition to meet DDRB uplift recommendations is equivalent to £219 (£209 in 2024/25 prices) per patient per year – including PCN funding. Based on current trends in appointment activity, for this money general practice will deliver in the region of five to six appointments per patient per year as well as cover most practice-related overheads and non-patient-facing activity.
This contrasts sharply with the unit costs (2024/25 prices) of other NHS services – a single consultant-led outpatient appointment (£203), ambulance (£272) or emergency care episode (£280) cost nearly as much as or more than a patient’s annual allocation for general practice. A non-elective inpatient short stay costs nearly four times as much (£824). I was able to present these comparisons to the MPs to highlight how little is spent on general practice relative to the cost of single episodes of hospital-based care.
We discussed how Lord Darzi had recognised GP partnerships as the fiscally most responsible part of the NHS and that this was directly related to the fact that we hold personal risk and liability unlike any other part of the NHS.
I emphasised the fact that with 90% of patient contact occurring in primary care, this offered the biggest opportunity to influence population health, NHS demand, and longer-term NHS spending.
The importance and value of continuity of care was a recurrent theme in our discussions. I observed that in a health system that seems to be delivering increasingly fragmented care, we are the only true generalists providing holistic medicine. We need to be valued and recognised as the specialist generalists that we are. “We are the foundations of the NHS, and you will miss us when we are gone”.
I ended the meeting with a plea that their health policy shouldn’t have unrealistic headlines promising undeliverable appointment deadlines, rather that it should aspire to deliver appointments to patients with the appropriate clinician within the appropriate time scale to meet patient need.
We will continue to make sure that the voice of our members is heard and that future policy recognises both the extraordinary value of General Practice and the realities within which our teams are working.
Dr Andy Purbrick
Joint CEO
Wessex Local Medical Committees Ltd