20 EDITORIAL
Don ’ t feed practices on secondary care ’ s scraps
Primary care is pivotal to the Government ’ s winter plan and needs to be funded accordingly , writes Emily Twinch
Emily Twinch is the editor of Nursing in Practice
In its 2019 Performance Tracker , the Institute for Government think tank noted spending on general practice had increased in the preceding six-year period .
NHS digital data confi rm real-terms spending on general practice rose by 17.9 % between 2010 / 11 and 2018 / 19 . The IFG tracker report said practices had managed higher workloads by ‘ becoming more effi cient and making greater use of physiotherapists and healthcare assistants ’. But , it added , ‘ decreasing continuity of care and lengthening waits for appointments suggest that these new working practices have not been enough ’.
That was before the Covid-19 pandemic . Since then practices must feel like they ’ ve been hit by a tornado , with scared patients , e-consultations , social distancing , the vaccine rollout and now the backlog swirling around them – all at a time of high staff absence .
In March 2020 the chancellor said part of an extra £ 6bn for the NHS would go towards more practice staff . But what became of that when , that same month , the country went into lockdown and practices were suddenly spending money on PPE , upgraded IT systems and protection screens ? Yes , primary care has had some £ 500m of Covid funding over the past year ( see page 10 ) but that seems pretty paltry alongside the £ 5.4bn over six months the Government has forked out , largely to hospitals , to clear the backlog . Of course , hospitals are vital . But , as healthcare gatekeepers , so are practices , and nurses are the backbone . Where would the country be right now without their vaccination expertise ? Primary care cannot be left to survive on leftovers .
When the Government fi nally unveiled its autumn / winter plan on 14 September – giving healthcare workers just a few days to put the programme into action – it meant at least 30 million more vaccinations over the next few months . But practices are bursting at the seams , coping with their own backlog . Primary care staff are seeing more people with mental health issues while struggling themselves to keep anxiety and depression at bay .
A Nursing in Practice survey in March suggested 35 % of practice nurses in England were thinking of leaving the profession . Ministers and the media need to remember general practice and not just focus on secondary care : nurses who work outside hospitals also need support and practices need a further cash boost just to keep going . The BMA has launched a petition calling on the Government to hand more money to practices to help with their ‘ unmanageable ’ workload , as part of its Support your Surgery campaign . I suggest it is well worth signing . Otherwise , as Devon LMC has warned , underresourced surgeries may end up on the brink of collapse , or even going over the precipice .
General practices are bursting at the seams , coping with their own backlog
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