The letter to Wes Streeting follows the imposition of a new GP contract variation from 1 October, and warns that the contract is a risk to patient safety.

It has been signed by almost 600 GPs and patients, with more than 150 copies sent to individual constituency MPs.

If general practice fails, the NHS fails

The message in the letter is clear: “If general practice fails, the NHS fails. Don’t let this happen on your watch.”

The new contract requirements demand that GP practices provide online access for patients with no corresponding investment, staffing, or infrastructure support.

Dr Ellen Welch, DAUK co-chair and a GP in Cumbria, said: “Every day, around 1.4 million people get appointments at GP practices compared with 67,000 attending A&E.

“People are getting through, we just don’t have enough capacity to see everyone.

Safe capacity

“Many practices are already operating beyond safe capacity.

“Opening up a new access route has simply created further demand that cannot be absorbed without more GPs and capacity.

“Instead, non-urgent consultations are being cancelled, staff are working late, and patients are waiting even longer.

“Clinicians are already under huge pressure and there’s a danger they will be stretched to breaking point and practices just won’t be able to cope.

“This hasn’t been fully thought through and we urge the Health Secretary to think again.”

DAUK letter

The letter to Mr Streeting calls for:

• A pause in the implementation of online access until full impact assessments and safety reviews are completed
• Proper resourcing for online access routes and service obligations. The GPs required to repair general practice exist – but the funding to employ them does not
• Support for a genuine dialogue with GP leaders, and to actively listen to the concerns that GPs are sharing through them

It concludes with a stark warning: “This contract variation does not modernise general practice, it destabilises it. And once lost, the community-based model of family medicine that defines the NHS will not return.”

The letter is the latest stage in a long-running campaign by DAUK’s GP committee. The campaign which aims to address the disconnect between policymakers and the realities faced by GPs.

Why Can’t I See My GP?

A copy of the book Why Can’t I see My GP?, written by Dr Welch, was sent to Mr Streeting, to every member of the Health Select Committee, and to all MPs who are doctors, following last year’s General Election.

Why Can’t I See My GP? highlights the crisis in general practice and offers some workable solutions.

Dr Steve Taylor, DAUK GP co-lead, said: “GPs have been called laggards and refuseniks for raising concerns about the new contract, our working conditions, and ultimately patient safety and satisfaction.

“We’re anything but laggards and refuseniks, and are providing 20% more appointments than a decade ago with fewer GPs.

Workable solutions

“But hundreds of GPs have signed our letter to say it can’t go on.

“DAUK’s GP committee has decades of experience and has put together workable solutions which we have shared with politicians.

“We’re here and ready to work with Mr Streeting and his team to solve the issues facing general practice.”

Read the letter to Mr Streeting.

DAUK GP committee

The DAUK GP committee is a group of volunteer GPs who advocate for general practitioners by addressing funding, workforce, and patient access and safety issues.

GP committee members provide briefings for politicians and develop policy proposals for improving general practice.

Members regularly raise awareness in the media of the ongoing GP crisis while countering misinformation and incorrect narratives around general practice. Please support their work by joining DAUK or donating to our GoFundMe.

The DAUK’s GP committee issued a 10-point plan to relieve the pressure on general practice and GPs, improve access, reduce mortality rates, lower hospital admissions and improve patient satisfaction.

It was set out during an online election briefing – Why Can’t I See My GP? The Great British Paradox – which was attended by prospective parliamentary candidates, as well as members of the media and DAUK members.

Dr Lizzie Toberty, DAUK’s GP lead, said: “We need patients to be able to see a GP who knows them and understands their needs in a timely way wherever possible.

“We’ve set out a 10-point plan that will allow that and restore general practice to being the cornerstone of the NHS.

General election manifesto

“We’re not asking for the earth – our manifesto for primary care is within reach of whoever makes up the next government.

“Our solutions are workable and will have a transformational effect on general practice.

“Follow them and continuity of care and all its benefits of reduced mortality rates, lower hospital admissions, and improved patient satisfaction will be the result.”

DAUK’s 10-point manifesto for primary care:

• Invest £3 per month per head of population to achieve a return to real terms funding last seen in 2015. That’s the equivalent of the price of cup of coffee per month. This does not need to be new money. Reallocate Additional Roles Reimbursement Scheme (ARRS) going to Pharmacy First and acute care hub pilots, which is worth £2 billion.
• Aim for ratios of patient to GP full-time equivalent of 1:1600 patients – and even lower in deprived areas – to reduce pressure ensure all patients have equitable access to GPs.
• Support partnerships with limited liability.
• Develop meaningful careers for new GPs by supporting fellowships, educational funds and innovation.
• Provide long-term benefits to enable GPs to stay rooted in their community.
• Develop email and messaging capacity for practices. Phones are ok, but this way no one needs to wait, and doctors can clearly see who is on the list.
• Relieve pressure on GPs by shortening secondary care waiting lists.
• No more NHS reform or reorganisation. Form a cross-party group to make longer term decisions for our health service and stabilise the NHS.
• Long term plan for estates. We need room for everyone, including any plan to expand places for healthcare students. We appreciate this is expensive but there needs to be long term aspirations
• Improve the IT infrastructure. GPs desperately need computers which don’t freeze and crash.

Dr Sarah Jacques, a GP based in Sussex and member of DAUK’s GP committee, shared her own powerful story as she discussed the immense strain that family doctors are working under.

GPs mental health

She highlighted the violence, abuse, and intimidation that GPs regularly face and the impact of the job on their mental health.

She said that an increase in demand and reduction in workforce, the scapegoating of general practice for wider NHS problems, and long waits for urgent and routine outpatient appointments all contributed to the pressure on GPs.

Dr Jacques said: “Without general practice, The NHS won’t survive. We see a vast number of the patients that use the NHS, and we deal with most of what people need from the health service.

“If we’re not there, secondary care services will just be completely overwhelmed.”

Dr Steve Taylor, a GP in Manchester and member of DAUK’s GP committee, told the briefing that GPs have 1.3m daily patient contacts, the largest of any part of the NHS, including hospital outpatient appointments (250,000), and A&E contacts (67,000), and yet it receives just 5.6 per cent of the NHS budget.

GP workload

He said: “And as the workload for GP practices has increased by 20 per cent, so funding has decreased by 20 per cent per patient.

“On average one GP has 2,295 patients when the widely recognised safe limit is one GP per 1,800 people. So in England, we’re 7,000 GPs short of safe levels, which adds even more pressure.

DAUK’s vice chair Ellen Welch, a GP in the North West of England, spoke about the solutions including financial investment into general practice, investment in the workforce, and continuity of care.

Cross-party NHS

She added: “Solution number we could achieve fairly quickly with significant results is to create a cross-party NHS.

“We don’t need more reforms. We need stabilisation of the NHS.

“Remove the NHS from short-term decision making based on party politics, and form a cross-party group to make longer term decisions for the provision of

health and social care.”

The briefing is available to watch again by clicking here.

Become a member of DAUK and support our work.

We invite all MPs and MP candidates to join the Doctors’ Association UK (DAUK) on Wednesday 19 June (10am to 11am) for an online briefing:

Why Can’t I See My GP? The Great British Paradox

Listen to four NHS GPs share their thoughts on the problems, the solutions, and just why general practice is worth saving.

Based on the book Why Can’t I See My GP?, a copy of which we sent to all 650 MPs in March, we ask our leaders to join us ahead of the general election to ensure GP teams are at the heart of their manifestos.

We need YOUR help.

An MP is much more likely to attend if a constituent asks them to, so we’re asking you to take two minutes to click the buttons below to tweet and email your MP to ask them to attend. Thank you!