January 2025 CEO Briefing
The Department of Health and Social Care (DHSC) have sought feedback following the Darzi review of the NHS which reported in September. These submissions will inform the 10 Year Health Plan which is due to be written and published in 2025 and likely to have a major impact on the national GMS contract for April 2026 onwards.
We have reviewed the Darzi review previously, and it is clear that
The Government needs to show a full understanding of the role of general practice as a profession and the importance of local practices.
We need more doctors and nurses in general practice, each full-time-equivalent GP providing care to fewer patients and able to provide safe and effective patient care; satisfy patients health needs and optimise health and wellbeing outcomes.
Only a strong and vibrant family doctor service will enable the continued evolution of care and services to tackle the NHS’ challenges and deliver an NHS fit for the future.
The shift from hospital to community-based care is critical, but not achievable without significant investment. In real terms it would take a 54% increase in investment to get back to the level in the 2004 contract and 11-12% just to get back to the real term levels of 2019 (the last 5-year settlement).
Evidence shows that effective high quality primary care is best delivered by expert generalists working with registered lists in defined geographic communities. The core funding that allows and supports this care delivery at individual and population level must be maintained and, where possible, increased rather than diluted.
Commissioners must be open and transparent with the public about rationing decisions: e.g. the increase in demand for general practice services, the worsening capacity/ capability gap of the wider NHS, and the safety impact of rationing services (for example by tightening referral criteria).
Everyone must employ robust clinical governance processes in deciding priorities, to address the increase in demand for family doctor services.
On 12 December, the DHSC announced three ‘vision working groups’ and seven enabling working groups. There are some GPs in these groups, all of whom also have a role with an ICB, NHS England or other non-clinical leadership role. It remains to be seen if the Government and NHS England genuinely want a thriving neighbourhood-based service. Afterall, GPs have been leading that since the NHS was established.
William Greenwood
LMC Chief Executive