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The Royal College of GPs (RCGP) has called on the government to increase investment in general practice, stating that they are now "seriously struggling" due to years of underfunding and neglect. As evidence of the mounting workload pressures faced by GPs, new research published by the RCGP has revealed that GPs are now responsible for an average of 2,300 patients each. Concerningly, the ratio has become even worse in areas of higher deprivation, where the need is greatest. The RCGP research found that over the past six years, the average number of patients per GP in areas with the highest level of income deprivation has risen by 260, marking a 12 per cent increase-nearly double the rate observed in the least deprived areas. In these areas, one GP is responsible for 2,450 patients, which is over 300 more patients than their counterparts in the least deprived regions. Addressing the RCGP's annual conference 2024 in Liverpool on Thursday, College Chair Professor Kamila Hawthorne said: "When I became a GP, it was normal to have a list size between 1,600-1,800 patients. The role was busy and challenging, but it was manageable. Our latest figures reveal that the average is now 2,300.

General practitioners (GPs) across England have made a resolute stand against proposed alterations in the 2024/25 national GP General Medical Services (GMS) contract put forth by the Department of Health and Social Care (DHSC) and NHS England. This firm opposition coincides with the declaration of an extended six-month strike by 33,869 junior doctors within the NHS, advocating for full pay reinstatement and reforms in the pay recommendation process. The latest survey conducted by the British Medical Association (BMA) has revealed that an overwhelming 99.2% of GPs in England are against any changes to the existing contract. The proposed amendments, slated for implementation from April 1st, 2024, encompass a meagre national practice contract baseline funding uplift of just 1.9%, notably falling short of recent inflation rates. This corroborates with GP Online poll that recently unveiled widespread GP dissatisfaction with proposed changes to the national GMS contract. 83% of GPs in favour of strikes cite pay and funding concerns, while burnout, high workloads, and patient safety also fuel discontent.

Community Pharmacy England (CPE) has urged pharmacy owners to maintain the safety of their services while managing the additional workload brought on by the collective action of GP services, starting today (Thursday, 1 August). General practices across England have begun implementing a work-to-rule strategy indefinitely, following a ballot of GP partners conducted by the British Medical Association (BMA). Under this approach, GP practices will strictly adhere to contracted hours and duties, performing only the tasks specified in their NHS contract. With fewer GP appointments available, it is anticipated that more patients will turn to their community pharmacies for help and advice. Therefore, CPE has stressed the importance of pharmacy owners maintaining the safety of their services, with a focus on the safe supply of medicines, during this period of GP collective action.

People in the UK are increasingly relying on community pharmacies for health advice and support as they are unable to access their general practitioner (GP). According to a recent report by the Liberal Democrats, there was a significant increase in the number of patients waiting four weeks or more to see a GP in England last year, rising from 12.8 million in 2022 to 17.6 million. Responding to this research report, the Royal College of General Practitioners (RCGP) highlighted that GPs are also struggling to meet the increasing demand for their services due to severe staff shortages. Dr. Victoria Tzortziou-Brown, Vice Chair of the RCGP, stated that the average number of patients each GP is responsible for has increased by 158 compared to five years ago. Although she acknowledged that many patients are forced to wait for weeks to see their GP, she said that doctors too are grappling with "unmanageable and unsustainable workloads" and "we can't keep doing more with less."

With the Pharmacy First services scheduled for launch end of this month, legislators explored the potential of community pharmacies to offer specific diagnostic and treatment services in the second public evidence session of pharmacy inquiry this week (January 16). The new service, which will enable pharmacists to offer advice and prescribe treatment for seven minor ailments, is expected to alleviate the pressure on the NHS, reduce GP workload, and cut waiting lists. But MPs and healthcare leaders also acknowledged that there's hesitancy and the mindset of 'GP first, not Pharmacy First' among members of the public. "We must accept that many patients are used to seeing their GP as their first port of call for many health conditions. Pharmacy First is welcome, but there are going to be some restrictions on how quickly some patients will want to take up some of those services, rather than seeing their GP," said William Pett, Head of Policy, Public Affairs and Research, Healthwatch England.

"It is crucial that patients can access care when they need it, whether from a pharmacist or a GP, " Paul Rees, Chief Executive of the National Pharmacy Association (NPA) has said. In response to a recent survey conducted by the General Medical Council (GMC) highlighting alarming trends among General Practitioners (GPs), the NPA has issued a warning about the growing crisis in the UK's primary care system. Rees emphasised the urgent need for government intervention, saying, "Only by reversing these cuts and providing pharmacies with a new funding deal will we be able to end the 8am scramble for appointments." The GMC survey reveals that there is a significant increase in the number of doctors reducing their working hours to safeguard their wellbeing, spotlighting concerns about the long-term impact on patient care. According to the report, nearly half of GPs ( 48 per cent) are struggling to manage their workload, with several resorting to decreasing their hours or declining additional work to protect their mental and physical health.

Shadow Health Secretary Wes Streeting outlined his plans for NHS reform on Friday (21 April), where he also mentioned a desire to see pharmacies take on more workload and pharmacists' clinical skills to be better utilised. In his speech, he also expressed concern at warnings from the pharmacy sector and pharmacy closures. The Company Chemists' Association (CCA) appreciated Shadow Health Secretary's desire to enhance pharmacies' role in primary care reform but also stated that the sector is in urgently needs a funding injection. Dr. Nick Thayer, Head of Policy at the Company Chemists' Association (CCA) comment: "We are pleased to see the Shadow Health Secretary recognise the enhanced role that pharmacies should play in primary care reform. Mr Streeting wants to see care brought closer to people's homes and more front doors into the NHS. With 89.2% of the population located within a 20-minute walk of a pharmacy, pharmacies do just that. They are essential to realising his vision of a 'neighbourhood health service'. Pharmacies could free up over 42m GP appointments annually, including 10m vaccination appointments. Urgent same-day appointments for minor conditions in pharmacies will immediately benefit patients by increasing GP access. The first step is for the Government to immediately commission a fully-funded Pharmacy First service in England.

There is no doubt that the pandemic has changed the way healthcare professionals work within the primary care setting. The advent of Covid-19 meant that we all had to rapidly modify the way we supported and met the needs of patients, some of whom saw the services they usually took for granted, virtually cease overnight. There are around 15 million people in England living with long-term health conditions including asthma. These people have the greatest healthcare needs of the whole population with 50 per cent of all GP appointments and 70 per cent of all bed days taken by this cohort of patients, and their treatment and care absorbing 70 per cent of acute and primary care budgets in England. This situation isn't going to improve any time soon. In the past, most people had a single condition, today multi-morbidity is becoming the norm. At the start of the pandemic, the Royal College of General Practice and British Medical Association issued guidance to practices on prioritising workload. This included the importance of maintaining long-term condition reviews in asthma, COPD and diabetes, along with appropriate transition of at-risk warfarin patients. These reviews were deemed as essential workstreams for patients considered to be at high risk. Traditionally, the unique skills set of a pharmacist has meant that we have played a major role in supporting these patients. I work with a team of over 90 clinical pharmacists who, in partnership with individual practices, PCNs, CCGs and STPs, help with the long-term management of people with chronic conditions. But the onset of Covid-19 meant that we now had to plug a potential gap in service provision, and quickly.

The Royal Pharmaceutical Society (RPS) has urged the government to amend medicines legislation to allow pharmacists to make minor amendments to a prescription without any protocol being needed. RPS wants to see a change in the law that makes the whole process of supply of medicines easier and quicker, enabling pharmacists to use their knowledge and expertise in medicines to better support patients. "At present a prescription can only be changed by a prescriber, which causes unnecessary workload for GPs and delays for patients," said RPS. RPS President Professor Claire Anderson said: "We want to see all pharmacists across the UK able to supply a different quantity, strength or formulation of a medicine (for example changing capsules to tablets) when required, to avoid unnecessary bureaucracy and the need for an SSP to be developed, signed and authorised by a Minister. In effect it would mean that pharmacists can help patients straight away - it would future proof the problem to some degree.