Dr Steve Taylor was speaking on national radio about a survey by Pulse, which found that an estimated quarter of GP referrals to secondary care are returned as unsolicited Advice and Guidance.

He told listeners of Times Radio that the additional workload was putting further pressure on an already overstretched general practice.

Dr Taylor said GPs were paid 20% less in real terms than 10 years ago as he called on the Government to invest in general practice to help ease pressure across the NHS and improve access for patients.

Underemployed GPs

He said there were around 3,000 underemployed GPs who could work more hours if practices had the resources to employ them.

“If the money was available today, we could have 10% more appointments tomorrow,” he said.

Dr Taylor said that hospital waiting lists had increased significantly since 2010, when around 2 million people were waiting for hospital treatment compared with approximately 7 million today.

“Over that period we’ve seen 20% more work being done in general practice,” he said. “Last month a record 35 million appointments took place in general practice, half of those with GPs. Compare that with the 2 million who attended A&E.

“GPs are really frustrated. We just want to see more funding in primary care, to employ the unemployed and underemployed GPs and get the whole thing working better again.”

Advice and Guidance

Advice and Guidance was introduced to help GPs seek specialist input while patients waited for hospital care, or before making a referral.

However, Dr Taylor said it had increasingly resulted in hospitals returning referrals to GPs with requests for further work to be carried out in primary care.

He said: “If I’m dealing with all the referral bounce backs, and I’m also dealing with the people that are waiting for hospital treatments, then there are going to be issues for me providing appointments for today.”

Listen to the interview with Dr Taylor on the DAUK Instagram.

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Doctors Association UK (DAUK) has written to health secretary James Murray urging the introduction of clear national standards to ensure patients referred to hospital by a GP are assessed by a doctor.

DAUK GP co-leads Dr Sarah Jacques and Dr Steve Taylor wrote to Mr Murray following coroners’ reports into the deaths of nine-year-old Dylan Cope and eight-year-old Ethan Hanson.

They were both urgently referred to hospital by their GPs with suspected appendicitis but, according to the coroners’ findings, were not assessed by a doctor after arriving at hospital.

The letter has been featured by The BMJ, Pulse and Doctors.net.uk

In it, Dr Jacques and Dr Taylor called on the government to introduce national standards requiring patients urgently referred to hospital by a GP to be assessed by a doctor.

The letter also asks to ensure that no patient with undifferentiated symptoms is assessed or discharged without doctor oversight.

DAUK has invited Mr Murray and Department of Health officials to discuss the proposals.

Read the letter in full.

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Doctors Association UK (DAUK) GP co-leads Dr Sarah Jacques and Dr Steve Taylor highlight the cases of nine-year-old Dylan Cope and eight-year-old Ethan Hanson.

In both cases, the children were appropriately assessed in primary care and urgently referred to hospital by their GP.

However, according to the coroners’ findings, neither child was assessed by a doctor after arriving at hospital.

Patient safety

Dr Jacques and Dr Taylor’s letter states: “These cases raise serious questions about the safety of current assessment systems in emergency departments and the roles of non-doctors.

“When a GP refers a patient to hospital, that referral represents a clinical judgment that is the equivalent of a medical consultant opinion in the community, and thus necessitates a further medical assessment.”

DAUK is urging health secretary James Murray to introduce clear national standards to ensure patients referred by GPs are assessed by a doctor on arrival in hospital.

They are:

• Any patient referred by a community GP to hospital by a GP must be assessed by a doctor in the hospital.
• No patient presenting with undifferentiated (undiagnosed) symptoms should be allowed to be assessed or discharged without the approval of a doctor.
• We ask the Secretary of State to review the current status of assessments in emergency departments to ensure patient safety is the priority and that doctors are involved in all cases of undifferentiated care and GP referrals.

Improvements in clinical practice

In their letter, Dr Jacques and Dr Taylor said: “It’s vital we ensure that the issues identified by the coroners in the cases of Dylan Cope and Ethan Hanson lead to improvements in clinical practice.”

DAUK has invited Mr Murray and Department of Health officials to discuss the proposals.

Read the letter in full.

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Speaking at events organised by the Independent Pharmacies Association and publisher Cogora, Dr Taylor highlighted the need for greater collaboration across primary care professions.

He used the platforms to argue for a more joined-up approach to funding and service delivery.

The first event, hosted by the Independent Pharmacies Association at The Belfry, brought together pharmacy leaders from across the country.

Primary care funding

Dr Taylor was invited to speak on the GP contract and the wider challenges facing primary care funding.

His presentation focused on the long-term decline in investment across primary care, including general practice and community pharmacy, and the need for the professions to work together to secure a greater share of NHS funding.

Dr Taylor said: “Primary care includes GPs, pharmacists, dentists and optometrists.

“Rather than competing with one another, we need to be making a collective case for greater investment in the services that provide the vast majority of patient contacts in the NHS.”

Networking

Dr Taylor said the session was well received, with many delegates approaching him afterwards to discuss the issues raised.

The event also provided valuable networking opportunities, including discussions with senior pharmacy leaders and representatives from across the healthcare sector.

The second event was the Community Pharmacy and General Practice Conference.

The conference was organised by Cogora, the publisher of Pulse and The Pharmacist, and the National Pharmacy Association

It brought together community pharmacy and general practice professionals at the National Conference Centre near the NEC.

Improving vaccine uptake

Dr Taylor delivered a presentation on immunisation programmes and the shared responsibilities of GPs and pharmacists in improving vaccine uptake.

A central theme of his talk was the need to move beyond competition and focus on unvaccinated people.

He said: “We shouldn’t be squabbling over the 70 per cent of people who are already willing to be vaccinated, we should be developing a joint strategy to reach the 30 per cent who aren’t.”

Dr Taylor’s comments were included in a blog by Pulse editor Sofia Lind on how the current funding arrangements can unintentionally encourage competition between GPs and pharmacists, when greater cooperation would serve patients better.

Alongside his presentation, Dr Taylor co-hosted the conference’s Hall of Heroes session with healthcare leader Tara Humphrey.

Collaboration and innovation

This session celebrated examples of successful collaboration and innovation in community pharmacy. He also participated in the conference’s closing plenary discussion.

Dr Taylor said the conferences provided an opportunity to build stronger relationships between general practice and pharmacy.

He said: “Primary care is vital in preventing illness and hospital admissions.

“The right drift of funding has seen secondary care funding increased while primary care has seen cuts over the past decades, particularly the past 10 years.

Ten Year Plan

“Many health plans have come and gone promising a shift to community care. All have failed and the Ten Year Plan seems to be the latest iteration.

“Investing in existing community neighbourhood centres, GP practices and pharmacies, seems to be a simpler solution for genuine community care.

“The government needs to rethink its strategy.”

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Speaking to Pulse Today, Dr Steve Taylor, GP co-lead for the Doctors’ Association UK (DAUK), questioned what the plans aimed to achieve.

Dr Taylor said: “What are we trying to invent here? Is it outpatients in the community or is it actually community care?

“I think there is a sort of mixed up approach that we’ve got going on here, and I’m slightly concerned that we are missing something in terms of what we already have, and how do we integrate that better.”

Dr Taylor pointed out that general practice already provides local neighbourhood care across the country.

He said: “There are already 6,300 neighbourhood centres in the community within walking distance of 85 per cent of the population.

“In a city like Manchester people can access hospitals relatively easily. Rural communities need local access.”

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Dr Jacques highlights the difficult balancing act of supporting valued team members and maintaining the financial sustainability of practices against a backdrop of rising employment costs and limited contract funding.

Writing a blog for Nursing in Practice, Dr Jacques said: “The challenge for partners is not a lack of willingness to reward staff, but the financial pressures practices are currently under.”

General practice funding

Dr Jacques’s blog examines the realities behind pay decisions, the impact of the 2026/27 contract settlement, and why wider reform of general practice funding is essential if practice nurses are to receive equitable and competitive pay.

She said: “Ultimately, the issue of practice nurse pay cannot be separated from the wider funding model for general practice.

Read Dr Jacques’s blog for Nursing in Practice.

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Dr Taylor, GP co-lead for the Doctors’ Association UK (DAUK) said the proposals reflect wider failures to properly fund general practice.

He was responding to the Government’s announcement of a £340 million expansion of the Pharmacy First scheme.

Dr Taylor acknowledged that pharmacies ‘form an integral part of Primary Care’ and for decades have ‘provided advice and guidance to patients’, despite being ‘significantly underfunded’.

Diagnosis and management

“However there are significant concerns that diagnosis and management of even ‘simple’ conditions might mean things are missed,” he said.

The Government says the changes, due to come into force this autumn, will allow more pharmacists with prescribing qualifications to treat patients directly without referral to a GP.

Five new conditions are expected to be added to the Pharmacy First scheme, although ministers have yet to confirm details.

Dr Taylor said: “If Pharmacies and GP practices were funded in proportion to the need then there would be no need for Pharmacy First as access to GPs would be there.

Pharmacy First

“Even the 3.3 million Pharmacy First consultations over the past 12 months needs to be put in context. This represents less than 1% of GP practice consultations of 1.5million a day.

“The broader question is whether pharmacies are the best place to put diagnosis and prescribing, or whether this is better in GP practices.

“Experienced pharmacists are likely to be more likely to know what they don’t know, it is debatable whether this can be true for all.”

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Dr Taylor contributed to a new investigation by Pulse into the ‘lottery’ of local enhanced services funding experienced by GPs.

He said: “You could be on the other side of the street from another GP surgery and not be able to offer a service, just because you’re in a different ICB.

Funding lottery

“It’s a lottery, depending on which part of the country you’re in – you really don’t know what you can get and what you can’t get.”

Read the Pulse investigation.

Dr Taylor has also spoken to GP Online for its report on how some additional roles reimbursement scheme (ARRS) GPs are facing redundancy or reduced hours due to budgetary issues.

Core contract

He said: “It reflects the complexity of funding streams in general practice … GP practices, the BMA, RCGP have all been asking for money to be moved to the core contract [to help practices hire GPs] rather than it being manipulated via ARRS.”

Read the GP Online report in full.

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Dr Sarah Jacques, GP co-lead for the Doctors’ Association UK, warned the plan risked undermining patient confidentiality, professional accountability, and public trust.

Speaking to GP Online, Dr Jacques said that while GPs broadly support better communication and appropriate information sharing across the NHS, the current proposals appear to extend beyond improving patient care.

Serious unanswered questions

She said: “In principle, I believe GPs support better communication and appropriate information sharing across the NHS.

“However, the current proposals appear to go far beyond improving direct clinical care and raise serious unanswered questions about confidentiality, governance, liability, transparency, and public trust.

“I think one of the biggest concerns is around the GP data controller role. Yet there has been very little clarity about what happens to those responsibilities under the single patient record model.

Health Bill

“GPs need to know whether they will still retain legal and professional liability for information that may ultimately be shared more widely or potentially altered by external organisations and providers.”

DAUK’s concerns around the Health Bill and the creation of a Single Patient Record have also been reported in Pulse Today.

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DAUK has been working with the Department for Work and Pensions and the Department of Health on the future of fit notes.

Dr Steve Taylor, DAUK GP co-lead, attended the launch event in Birmingham, where details of the four pilot schemes were announced.

Fit notes

He said: “We agree the current system of fit notes isn’t working well for patients, GPs and employers.

“It often lacks the nuance to deal with specific work situations and reasons that people have for not being able to work their full or part of their role. 

“We hope these pilots will give the opportunity to explore a different way for people to engage with periods of ill health and ways to make work more accessible and achievable.

Pilot schemes

“This recognises that GPs aren’t always best equipped to understand the options for work and we hope that active engagement between patients, GPs, employers and this new service will provide a better experience for everyone.”

The small-scale pilots will be held in Coventry and Warwickshire, Birmingham and Solihull, Lancashire and South Cumbria, and Cornwall and the Isles of Scilly.

The Department for Health said the pilots are ‘exploratory and flexible, designed to test and refine different delivery models through a test and learn approach’.

DAUK survey

DAUK’s own GP survey highlighted strong professional support for reform.

Among respondents, 69% said fit notes should no longer remain within GP remit, while 85% supported transferring responsibility to a dedicated new service. Nearly half backed a return to four-week self-certification, and 94% reported that refusing a fit note negatively affected the doctor–patient relationship.

Dr Taylor said: “It is important that no one is forced to work who cannot, but it is also important that those who can, should be encouraged and given options to work.

“This could be a great improvement and we look forward to seeing the outcomes from these four pilots.”

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