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"However, while fax machines may be terribly old-fashioned, they do work and remain a highly valued and reliable form of communication between many GP surgeries and their local hospitals, nursing homes and pharmacies.
"A wholesale switchover to electronic communication seems like a brilliant idea but for some practices it would require significant financial investment in robust systems to ensure their reliability was at least as good as the trusty fax machine, as well as having the time to embed - neither of which we have at present as GP teams are already beyond capacity trying to cope with unprecedented patient demand.
"GPs are tech fans, not technophobes, and we have been calling on the Government for significant investment in our core IT infrastructure, some of which is archaic, so that all GP practices have technology that improves communication, works for patients and makes the working lives of GPs easier."
She said: "Despite the best efforts of GPs and our teams, who are working incredibly hard to deliver more consultations than ever before, our patients are waiting too long to secure a GP appointment. We know this is frustrating for them and their families, and it's frustrating for GPs and our teams too. We want to deliver timely care to patients, in the early stages of illness, to avoid conditions getting worse, when they can be both more distressing for patients, and more costly for the NHS.
"We also want the time to deliver care for patients - for many who are living with multiple, long term conditions, the standard 10-minute consultation is no longer fit for purpose - but offering longer consultations, means offering fewer, and as this data shows, patients are struggling to get an appointment as it is.
"With this in mind, it's encouraging and a great testament to the hard work and dedication of GPs that more than 40% of GP appointments are made on the same day the patient is seen, so we are confident most of those who are acutely unwell are being provided for.
"Today's data also shows that many patients are not attending appointments when they have made them. There can be a number of reasons for this, and in some cases a patient not attending an appointment can be an indication that something has gone wrong - but this waste of resources is frustrating, and we would urge patients to let us know if they can't attend as soon as possible, so that we can offer that time to someone else who really needs it. To this end, practices are using electronic methods, such as SMS reminders, to encourage patients to keep their appointments, or cancel them in a timely manner.
"Ultimately, we are calling for general practice to receive 11% of the overall NHS England budget as part of the forthcoming 10-year plan for the NHS, so that our service can continue to deliver the care our patients need and deserve, and keep the rest of the health service sustainable.
"On a wider note, it is very welcome that NHS England has started collecting and analysing GP appointment data - this is something we have long called for. There is a long way to go to improve the quality of this data - and the College is working hard in this regard as our own Research Surveillance Centre has recently started collecting comprehensive data on workload in general practice - this will be invaluable for future planning of our services."
89% of GPs surveyed are concerned that their increased workload during the winter months will negatively affect their ability to deliver patient care.
This figure is unsurprising given that 95% of GPs agreed that their workload increases over winter.
The College's Patient Group in Northern Ireland is reminding people about the important '3 Before GP' message and urging people to think carefully about the support and treatment they might require from the health service during this busy period.
RCGPNI Patient Group Chair Karen Mooney said: "Despite the pressures in the health service, all year round we can rely on our GPs for support and treatment when we need it. GP teams work very hard in challenging circumstances to meet the demand from patients and do what they can to care for us in the community.
"This winter, we know that our GP practices are going to be under immense strain, and we can do our bit to help support our health service. Think about what you really need; think 3 Before GP. Can you care for yourself and manage minor ailments at home? Can you find the advice you need using safe and reputable online resources such as the NI Direct Stay Well website? Can you seek advice from your community pharmacist?
"We all have a responsibility to help protect our health services and to make sure that those who are the most ill and vulnerable in our society are able to access the care that they need."
RCGPNI Chair, Dr Grainne Doran, said: "GPs strive to provide the very best care to all of our patients. Over the winter period, there is no doubt that our workload hugely increases.
"For more minor conditions such as coughs and colds, patients can get great advice and over the counter medicines from local pharmacies. This will be faster and more efficient and will help ensure appointments with a doctor are available for those who need them most. But it is important to remember that if you think you need medical attention, or if symptoms don't improve, do not hesitate to seek medical advice.
"I am grateful for the insight brought by the RCGPNI Patient Group in supporting and championing the '3 Before GP' initiative this year."
“GPs and our teams are working incredibly hard to ensure patients get the care they need, but this simply isn’t sustainable without a robust workforce or adequate resources - and as this report shows, many doctors across the NHS are moving away from frontline care due to the intense pressures they are facing.
“It supports our own research, released earlier this week, that found a staggering 31% of GPs said they are unlikely to be working in general practice in the next five years - many citing stress and early retirement as the reasons why.
“Workload in general practice is escalating both in terms of volume and complexity. Yet, the share of the NHS budget general practice receives is less than it was a decade ago, and GP numbers are lower than they were two years ago.
“As GPs, we want to be able to deliver the best care we can to our patients, but there comes a point when this simply isn’t safe for patients, or for our own health and wellbeing.
“NHS England and Health Education England have been doing great work improving recruitment to general practice, but if more GPs are leaving than are entering the profession, we are fighting a losing battle. We need to see initiatives implemented to tackle unnecessary workload in general practice, and make it a more sustainable environment to work in, so that we can keep hard working, experienced GPs in the profession for longer, delivering patient care.
“Ultimately, we need to see NHS England’s GP Forward View, which promises an extra £2.4bn a year for general practice and 5,000 more GPs delivered in full and as a matter of urgency, and for general practice to receive 11% of the NHS England budget as part of the forthcoming 10-year plan for the NHS.”
The College has called on the Welsh Government to commit to "giving general practice 11% of the Welsh NHS budget, in turn giving patients the type of care they need." The call comes on the day Welsh Assembly Members debate the draft budget for 2019-20.
'Transforming general practice
' presents a snapshot of the state of general practice in Wales. It shows high levels of stress, concern about the future, and worry about financial sustainability.
The report revealed that 42% of GPs believe it is financially unsustainable to run a practice, with 82% of those citing 'insufficient core funding' as the cause. 85% of GPs say the funding available from all sources for general practice is not enough (43% 'nowhere near enough', 42% 'not quite enough').
Dr Mair Hopkin and Dr Peter Saul, Joint Chairs of Royal College of General Practitioners Wales, said:
"This report highlights the true cost of underfunding in Welsh general practice and demonstrates that things need to change.
"More of the same won't deliver the best results for an ageing population with an increase in multiple, long-term conditions. Patients need to be able to access services in their community and get help before issues get worse.
"Our recommendations for change are geared towards supporting GPs to deliver the very best care for patients. It needs to be underpinned by a step change in funding, giving general practice 11% of the Welsh NHS budget, in turn giving patients the type of care they need.
"This report presents comprehensive evidence that general practice needs more support and outlines constructive suggestions to make it happen. Things need to change. GPs deserve better and patients deserve better."
The survey of 1,094 GPs in England found:
- 31 percent of GPs said they are unlikely to be working in general practice in five years with stress and retirement cited as the main reasons for this.
- 5 percent of GPs* report that their practice is likely to close in the next year. These are not practices that are merging with others.
- 37 percent of GPs* said that in the practice where they work, there are GP vacancies that have been open for more than three months.
Efforts to retain the workforce need to replicate the 'excellent' work that has gone into increasing recruitment to general practice, which has seen more GPs in training than ever before, the College is saying.
It has also analysed the latest provisional workforce data from NHS Digital for September 2018, published last month, which showed an increase of 41 from September 2017**. However, looking back to September 2015 – the last set of workforce data before NHS England's GP Forward View was announced, with a pledge of 5,000 more GPs by 2020 – the total number has dropped by 460.
Taking the data at Clinical Commissioning Group-level, it has identified where in the country has seen the biggest increase in GP numbers – with one area seeing an extra 87 GPs since September 2015 – and where has seen the biggest decrease.
Areas with biggest increases in GP numbers between Sept 2015-Sept 2018:
- NHS Liverpool CCG (87)
- NHS Northern, Eastern and Western Devon CCG (67)
- NHS Kernow CCG (54)
- NHS Lambeth CCG (45)
- NHS Gloucestershire CCG (41)
Areas with biggest decreases in GP numbers between Sept 2015-Sept 2018:
- NHS Horsham and Mid Sussex CCG (-52)
- NHS Walsall CCG (-33)
- NHS Portsmouth CCG (-29)
- NHS Hull CCG (-22)
- NHS Thanet CCG (-19)
The College says that a primary factor in GPs leaving the workforce prematurely is excessive workload, which has risen substantially in recent years both in volume and complexity, yet the share of the NHS England budget general practice receives is less than it was a decade ago, and GP numbers are lower than they were three years ago.
Last month the College renewed its long-standing calls for general practice to receive 11% of the overall NHS budget as part of the forthcoming 10-year plan for the NHS.
The recent announcement that £3.5bn of the promised £20.5bn NHS uplift would be allocated for primary and community care shows a commitment to supporting healthcare services closer to home for patients. However, general practice currently receives 9.5%*** of the NHS England budget, and the College has called for assurances that general practice, specifically, will be a key recipient of this new funding.
It says 11% of the budget for general practice would enable:
- Larger practice teams, which would enable GPs to spend more time than the standard 10-minute consultation with patients who need it.
- A wider range of healthcare professionals to provide a wider range of clinical services in GP surgeries.
- IT systems allowing more surgeries to use video consultations as part of a standard range of consultation options, and to enable joined-up care across the NHS.
- Modernised, fit-for-purpose surgeries as the 'hub' of the community
- A bigger workforce, where more healthcare professionals will choose general practice as a career and are supported by better-funded training placements in the community.
Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: "All GPs are overworked, many are stressed, and some are making themselves seriously ill working hours that are simply unsafe, for both themselves and their patients - it is making them want to leave the profession. It is forcing some GPs to hand back their keys and close their surgeries for good.
"This is having a serious impact on many of our patients, who are waiting longer and longer to secure a GP appointment. But it also means we don't have the time we need with patients – particularly the growing number living with multiple, complex conditions – so the standard 10-minute appointment is simply unfit for purpose. GPs often find ourselves fire-fighting by prioritising the urgent cases, whereas the strength of general practice is to prevent disease and identify conditions in the early stages, to avoid them becoming more serious – and costlier to the health service.
"About a third of the GPs we surveyed said they were unlikely to be working in general practice in five years' time. This is gravely concerning. We are talking about highly-trained, highly-skilled doctors, that the NHS is at risk of losing – some will retire, which is to be expected, but many are planning to leave earlier than they otherwise would have done because of stress and the intense pressures they face on a day to day basis, whilst simply trying to do their best for their patients.
"These GPs are the ones we need to be focussing our energy on – to make their working situation safer and more sustainable.
"NHS England and Health Education England have done excellent work, supported by the RCGP and others, to encourage more doctors to specialise in general practice and we now have more GPs in training than ever before. But GP specialty-training takes three years, and if as many GPs are leaving the profession as entering it, we are fighting an uphill battle, when realistically we need thousands more.
"We need to see this level of effort replicated in initiatives to retain GPs already in the profession, to reduce our escalating and often unnecessary workload, and to support GPs and our teams' own health and wellbeing.
"The RCGP is calling for general practice to receive 11% of the overall NHS budget as part of the forthcoming 10-year plan for the NHS. Investing in general practice is investing in the entire NHS. It is an investment in good patient care."
Her Majesty's Inspectorate for Constabulary Fire and Rescue Services really needs to check its facts (GPs dump mental health cases on us, complain police – November 27 2018). GPs and our teams have the greatest respect for our emergency services, and we collaborate with them on a daily basis, but to accuse hardworking family doctors of 'shunting' patients after closing our doors at 5pm is disgraceful, disappointing and demeaning.
Today alone, over 1m patients will visit their GP surgery, and dedicated GPs and their teams are working harder than ever to try and keep up with rising patient demand at a time when we also have a severe shortage of family doctors.
We are managing complex conditions in the community - including serious mental health issues - that even a decade ago would have been automatically referred to hospital consultants.
My members routinely report working over 12 hours every day – indeed at my own surgery in Lichfield on Monday, I had over 100 patient contacts - so to say we close our doors at 5pm is completely untrue and unfair.
GP surgery core hours are 8.00-18:30 and all practices in England now offer extended routine services, whether in the evening until 20:00 or at weekends. Outside these hours, GP-led out of hours services will take responsibility for the care of our patients with urgent health needs.
Even when our doors are 'closed', we are still working on referrals, following up test results and all the tasks that were once part of our working day but now have to be done in our own time because we are constantly running to catch up.
Our emergency services are under enormous pressure, but so is general practice, and we achieve more for our patients by supporting each other and working together, rather than using GPs as an easy target and apportioning inappropriate blame.
Professor Helen Stokes-Lampard, Chair
Royal College of General Practitioners
30 Euston Square
London, NW1 2FB
She said: "GPs are in an incredibly difficult position when it comes to making referrals or ordering blood tests and other investigations, in that we get criticised when we do, and criticised when we don't. Ultimately, our priority is to our patients and we will work in their best interests.
"This research looks at the increase of number of requests for tests GPs make, but not the reasons why and whether they were appropriate – and both of those must be key when making a judgement about whether an increase is positive, or not.
"The fact that the last 15 years have seen more varied and more accurate diagnostic tests become available in the NHS is a good thing – but these do come at a cost. It's obviously important to consider NHS resources when deciding to make a request for a test, but GPs and their teams don't take the decision lightly, or if they don't think they will genuinely help in narrowing down what might be wrong with a patient.
"We're now serving a growing and ageing population, and where many patients are living with multi-morbidities, so, as this report shows, there will be a completely appropriate increase in the number of tests being carried out in the community as these conditions and the medications used to treat them are monitored. We would argue that GPs and our teams need far better access to diagnostic tests in the community, so that we can make a more informed decision about requesting more specialised tests or making a referral to a hospital colleague."
What Once Was Imagined
(WOWI), named after a quote by William Blake, is the creation of long-time collaborators, textile artist Susie Freeman and Bristol-based GP, Dr Liz Lee – together known as Pharmacopoeia
WOWI will feature 31 installations, many on display for the very first time and some created especially for the exhibition.
Each piece explores a different health issue, with some works relating to specific patients: Charlie and Lucy
, for example, considers the latest gene therapy being used to treat cystic fibrosis, while Miss Essex is a giant handbag adorned with all the pills one woman hoarded during treatment for her mental health.
Many pieces are constructed using real medication and medical devices. For example, Larking About
, a handbag decorated with long-acting reversible contraceptives known as LARCS, looks at changing trends in recommended contraception while others, such as Feast, a coat made from the packaging of all the food eaten on Christmas Day, addresses a culture of excess and lifestyle habits that can contribute to long-term health conditions.
The new pieces join two that are part of the RCGP's permanent collection, and already on display at 30 Euston Square: Jubilee
, a wedding dress made of the number of contraceptive pills a woman could take during her married life, and Armour, made with the empty packets from medicines one of Dr Lee's patients took in the last five years of his life.
Some key pieces in the exhibition include:
- Sonia: a cascading silver muslin coat covered in three years' worth of lupus medication packets. Lupus, an autoimmune disease once considered untreatable, attacks the body's immune system causing multi-organ failure: "taking so many pills is a burden, but it's saving Sonia's life,” says Dr Lee;
- Steve's Scarf, is made from pills prescribed by Dr Lee to help manage her patient Steve's heart disease, arthritis and diabetes – a stark reminder of the UK-wide rise in patients living with multiple, chronic conditions as people live longer;
- Wave: a depiction of Freeman's own experience of depression - a delicate stretch of blue fabric decorated with the packets of her own medication: "for some people it presents as 'black dog' but for me it was a deep blue," she explains;
- Bristol Silver: a waterfall of pill packets for common conditions and chronic disease management, collected from one Bristol pharmacy over the course of a month;
- WOWI flowers: a series of works depicting colourful flowers made from pills to treat myriad conditions from indigestion to tuberculosis.
Using an analogy of her own father to explain the concept of WOWI, Dr Lee, said: "My father, Dr Alan Baskerville Lee, was one of the first College members, and I have vivid childhood memories of him endlessly taking indigestion tablets.
"In the 1980s he tested positive for helicobacter; a bacterium associated with stomach ulcers. He took a one-week course of triple therapy: amoxicillin, metronidazole and omeprazole and his indigestion was cured.
"That's an extraordinary example of medical progress and how it has transformed the miserable symptom of indigestion for many millions of people."
On the other hand, Dr Lee acknowledges the downside of medication: "It can be a burden. I take statins and can't bear it, although I know it's for a reason. Every evening when I take the tablets it makes me feel old, it's a reminder of my mortality.
"GPs are acutely aware that we must be cautious about the medications our patients take. There is an important conversation to be had, and our patients need to be a part of it, about alternatives to medication, as well as what can be done to prevent people becoming sick in the first place."
Freeman added: "We often hear about how bad pills are for us, but modern medicine has worked wonders for millions of people and is the reason why so many of us are still here today.
"Many of the conditions showcased in our exhibition were once a death sentence, but now, thanks to these tiny tablets, people are living healthier and longer than ever once imagined."
Professor Mayur Lakhani, President of the Royal College of GPs, said: "It's an absolute honour to host WOWI at 30 Euston Square, the home of general practice and the headquarters of the RCGP.
is a unique blend of art and medicine, and WOWI explores several pertinent issues for general practice.
"It celebrates advances in medical research that mean our patients can live longer, and diseases that were once seen as a death sentence are now treatable. But it also explores emerging challenges facing medicine, such as overdiagnosis, and asks important questions such as 'are we simply prescribing too many pills?'
WOWI will be showing at the College from November 28 to May 2019 and is free
She said: "Technology has the potential to transform healthcare, and can play a key role in getting people more involved in their health, and living healthier lives.
"Devices can be used to incentivise walking a certain number of steps a day, for example, or for people living with long-term conditions, to monitor things like blood pressure.
"However, new technology and gadgets can be expensive, and we must be sure that if we are recommending certain devices to patients that we are sure of the reliability and evidence behind them, and that we are not leaving more socio-economically disadvantaged patients, or even just our less tech-savvy patients behind.
"It's also a reality that many patients might not understand how to interpret the data that their devices are feeding to them, and seek help from a healthcare profession to interpret it – in many cases this wouldn’t be a good use of GPs' scarce time.
"When we're talking about patients' data – collected via their technological devices – being used to target preventative health interventions to them, it is the case that the more detailed the data we have about patients, the better. But patients must also consent to it being used, and be completely clear what it may be used for - any interventions must also be handled sensitively, so as not to cause unnecessary alarm.
"Ultimately, any new innovation or way of working should be rigorously and consistently evaluated in terms of its benefit for patient, and its impact on general practice and the wider NHS – and we have called for a rapid evaluation system in order to do this."
"GPs take their role in the timely diagnosis of cancer extremely seriously, and we're often the first port of call for patients wanting to get symptoms checked or who are simply after reassurance.
"However, as this report highlights, a key factor in being able to diagnose patients in a timely way comes down to having access to the right diagnostic tests – and GP access to appropriate tests in the community is currently amongst the lowest in Europe.
"The report is also right to acknowledge that GPs are in a very difficult position when it comes to referral and face harsh criticism if they refer too many patients to specialist care, and complaints if they don't refer enough.
"Despite these difficult circumstances, GPs are doing a good job of detecting cancer – something that can be very hard in general practice, particularly within the constraints of the standard 10-minute consultation, as several cancers start with very vague, non-specific symptoms which are similar to many other, more common conditions.
"Figures show that 75% of patients found to have cancer are referred after only one or two consultations, and in the last five years the proportion of cancers diagnosed as an emergency has dropped from 25% to 20%. A higher proportion of patients are also being diagnosed at an earlier stage of the disease.
"But without access to the right tests, this is simply not sustainable. We desperately need for GPs and our teams to have better access to high quality diagnostic tools in the community and the appropriate training to use them.
"Cancer must be a priority in the forthcoming NHS Long-Term Plan, but so too must general practice as a whole. Investing in general practice is an investment in the entire NHS - by having more resources and more GPs in the community, we can deliver the best possible care to all our patients, including those with cancer, and those we suspect of having cancer."
The Council also passed a motion to oppose the UK’s exit from the European Union.
The full text of the motion that was passed was:
“Recognising that leaving the European Union may damage the recruitment and retention of the healthcare professional workforce in the United Kingdom;
Recognising that leaving the European Union may potentially damage the mutual recognition of the qualifications of healthcare professionals between the European Union and the United Kingdom;
Recognising that leaving the European Union may damage recruitment to, and retention of, the social care workforce;
Recognising that leaving the European Union may damage cross-border arrangements for healthcare between Northern Ireland and the Republic of Ireland;
Recognising that leaving the European Union may damage reciprocal healthcare arrangements between the European Union and the United Kingdom, including eligibility for the European Health Insurance Card;
Recognising that leaving the European Union may damage public health in the United Kingdom and international cooperation on public health;
Recognising that leaving the European Union may damage the United Kingdom’s access to medicines, devices and radioisotopes;
Recognising that leaving the European Union may damage scientific collaboration, scientific and medical research programmes, participation in international clinical trials, including pharmaceutical research studies; free movement of scientists, including medical researchers; and collaboration between universities in the United Kingdom and the European Union;
Recognising the need for the facts about the damage to the UK healthcare professional workforce, public health, access to medicines, devices and radio-isotopes, and damage to the National Health Service, science, research and universities to be put before the citizens of the United Kingdom;
The Council of the Royal College of General Practitioners believes that the objective, non-partisan evidence in relation to the deleterious effects of Brexit on health and healthcare means that the College should oppose Brexit, because the object for which the College is incorporated is ‘to encourage, foster and maintain the highest possible standards in general medical practice’; because the College is obliged ‘to take or join with others in taking any steps consistent with the charitable nature of that object’; and that object would be grievously undermined by Brexit.
The Council of the Royal College of General Practitioners believes that the public should have a final say on the Brexit deal, including the options of accepting the deal, rejecting the deal, and remaining within the European Union.”
Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: “The College has considered carefully the implications of taking a view on Brexit, particularly given our status as a registered charity.
“We are also a membership body with more than 52,000 members, all of whom will have their own views on the UK exiting the European Union, but the level of feeling by UK Council – who have been elected by the membership to represent their interests – was that the risks of Brexit to the NHS and patient safety and care were significant enough to take a stance.
“The motion to oppose Brexit was passed with 46 voting for, 11 voting against and 6 abstaining. The motion to support a People’s Vote was passed with 38 voting for, 18 voting against and 7 abstaining.
“We will now consider how the College can take these decisions forward.”
"One striking and stark trend is the growing number of young women suffering from emotional disorders, such as depression and anxiety. This could be an indication of greater awareness of mental health problems in society, and more people being willing to come forward and seek medical attention for them – but it is also a reflection that it is an incredibly stressful time to be a young person.
"Social media can perpetuate unrealistic expectations for people to live up to, and it can make the pressures of life relentless and inescapable, which can certainly have a negative and serious impact on people's mental health and wellbeing.
"The College has been calling for better access to specialist mental health services for children and young people in the community for some time. We desperately need more, and more varied, mental health services, close to home where they can be of most benefit for our patients – and GPs need to have better and quicker access to these services for our patients.
"NHS England's GP Forward View pledged for every GP practice to have access to one of 3,000 new mental health therapists – we need this delivered in full and as a matter of urgency. We also need more time to spend with our patient with complex conditions, which mental health conditions almost always are.so that we can continue to provide the best possible mental health care to our young patients."
"It is good news to see GP numbers rising after such a steep decline in recent years – and these figures, albeit provisional, show that we have over 40 more full-time equivalent GPs delivering care in the community than this time last year. The trajectory is on the up. We now need to see this momentum sustained and accelerated, so that we have the sufficient numbers of GPs we need in the future.
"We applaud the efforts by NHS England and Health Education England that have gone in to encouraging medical students to choose general practice, something the College has been heavily involved in, and we now have more GPs in training than ever before. But it takes a long time to train a GP and we still need to see urgent initiatives implemented to retain our existing GPs, and to address the unsustainable workload family doctors and our teams are facing on a daily basis.
"We are also encouraged by the rise in numbers of members of the wider practice team we have seen in the figures today, who all play a vital role in supporting GPs to deliver patient care close to home.
"General practice is at the frontline of delivering NHS patient care, with GPs and our teams making more than a million patient contacts every day – alleviating pressures across the health service, including in Emergency Departments, in the process. Yet the share of the NHS budget general practice receives is less than it was a decade ago, and the GP workforce is still smaller than it was when NHS England’s GP Forward View was announced more than two years ago.
"We have heard today of £3.5bn extra a year for primary and community care as part of the forthcoming long-term plan for the NHS – it is reassuring that the Government recognises that general practice service is central to the long-term sustainability of the NHS and patient care. But the long-term plan must also be underpinned by a coherent, properly-funded workforce strategy, and address the adverse impact workforce pressures are having on our profession and the care we are able to deliver to our patients in the community.
"Investing in general practice is investing in the entire NHS. It is an investment in good patient care."
"Any investment in patient care in the community is welcome – and it's essential that general practice, specifically, is at the heart of these plans and a key recipient of this new funding.
"The Prime Minister's announcement demonstrates recognition at the highest levels that a strong general practice service is central to the long-term sustainability of the NHS and patient care. It is an important step forward to meeting our calls for our service to receive 11% of the overall NHS England budget, and achieving some of the College's aspirations for the future of general practice, particularly around providing a wider range of services in the community – but it certainly doesn't go all the way.
"GPs and our teams make more than a million patient contacts every single day. Our workload has increased substantially over the last decade, yet the share of the NHS England budget general practice receives is less, and the GP workforce has actually fallen.
"As a result, GPs are working far beyond what is safe or sensible, working ever-increasing hours due to the rising volume and complexity of patient demand, and then facing a mountain of paperwork. It is relentless, and it isn't safe for anyone involved.
"This is why we are today urgently renewing our calls for general practice to receive 11% of the overall NHS budget as part of the forthcoming 10-year plan for the NHS. This would allow us more time to care for our patients who need it; a larger general practice workforce leading a wider range of healthcare professionals to deliver care tailored to our patients' needs; and enhanced technology, so that GPs can broaden the range of consultation options for patients and enable seamless care throughout the NHS.
"The forthcoming NHS long term plan is an opportunity to ensure general practice receives the investment it desperately needs, so that we can continue to deliver the care our patients deserve. We look forward to more details about the plans announced today, and how the long-term plan will increase funding for general practice over time, so that we can reach the necessary 11% of the overall NHS England budget as soon as possible.
"Investing in general practice is investing in the entire NHS. It is an investment in good patient care."
She said: "Antibiotics are excellent, vital drugs when used appropriately - and for many bacterial infections there is often no alternative treatment available.
"GPs are already doing great work to reduce antibiotics prescribing and will only recommend them if we genuinely believe they will help the patient sitting in front of us. But antimicrobial resistance is a society-wide issue, and GPs cannot be held responsible for tackling it on their own.
"We need to get to a stage where antibiotics are not seen by patients as a 'catch all' for every illness. Sore throats, for example, are usually caused by viral infections that antibiotics will not help – they are also self-limiting and will get better on their own, with symptoms that can be relieved with paracetamol and other over the counter remedies.
"It's crucial we continue to get this message out, which is why we're pleased to support all campaigns to reduce inappropriate use of antibiotics to make sure we can carry on delivering safe, effective care to our patients both now and in the future."
She said: "Given the intense pressures currently facing our NHS, it frankly comes as little surprise to hear that an impending workforce shortfall will put the forthcoming NHS long-term plan at risk, if it is not comprehensively and effectively addressed from the outset.
"Workforce shortages are, as this report shows, being felt right across the NHS – and general practice is no different. Workload in our profession has escalated over the last few years in both volume and complexity, but our workforce is actually falling. We are currently short of at least 6,000 GPs in England, and if this isn't addressed, it is our patients who will ultimately bear the brunt by not being able to see their GP when they need to.
"GPs and our teams make the vast majority of NHS patient contacts and in doing so we alleviate pressures from other areas of the NHS, where care is more expensive. The long-term plan – underpinned by a coherent, properly-funded workforce strategy - must recognise and address the adverse impact workforce pressures are having on our profession and the care we are able to deliver to our patients in the community.
"GP trainee numbers are at an all-time high, but it takes 10 years to train a family doctor from entering medical school and efforts to bolster our workforce for today's patients are falling short of expected targets, leading to ever-increasing waiting times, burnt out GPs, and quality of care being put under threat.
"As well recruiting more doctors, we also need schemes to reduce the unnecessary and bureaucratic workload GPs are currently facing, and retain experienced GPs in the profession, not only for the benefit of our patients, but to also help teach and nurture the next generation of general practitioners.
"We need to see NHS England's GP Forward View, which promises an extra £2.4bn a year and 5,000 more GPs, delivered in full, as well as our additional ask of another £2.5bn a year as part of the forthcoming NHS long-term plan, to be delivered as soon as possible, to alleviate pressure elsewhere in the health service and fundamentally, keep our patients safe."
"This error has put patients at risk, and it will undoubtedly cause women more anxiety. It is vital everything is done as a matter of urgency to rectify the situation, and ensure all affected women are informed – particularly those who have not received their test results.
"We urge women not to panic and to await further information - we understand that NHS England are already working to contact anyone who has been affected. Our GP members will also be extremely concerned and need to be comprehensively informed as to how to advise patients for the best.
"This is the second blunder of its kind this year, and we all need answers about why this has happened and assurance that it will not happen again.
"We will be asking NHS England to urgently and seriously review its contract with Capita – this is the latest in a long line of serious errors made by the company, and it is clear to us that they have not properly understood the scope or complexity of the work they have bid to do to support primary care."
84% of GPs surveyed expressed concern that increased workload will negatively affect their ability to deliver patient care this winter.
This figure is unsurprising given that 96% of GPs said their workload increased in winter months, with 94% reporting that increasing numbers of patients are seeing their GP every winter.
RCGP Wales has said the findings demonstrate "a pressing need to boost the GP workforce", re-iterating calls for an increase in the number of GP training places in Wales. Numbers of training places in Wales are significantly behind the rest of the UK.
The College has also called for patients to have more information about the variety of options available to them in primary care. The RCGP Wales survey showed that only 51% of GPs felt there is enough information available to patients about what they should do if they feel unwell during the winter.
On Tuesday afternoon the Cabinet Secretary for Health and Social Services will be making a statement on 'Winter Delivery Planning' in the Welsh Assembly.
Dr Peter Saul, Joint Chair of Royal College of General Practitioners Wales, said:
"We already have a stretched GP workforce, having to work incredibly hard to try and meet patient demand through the year, so it is to be expected that GPs are concerned about what the winter months will mean for patient care.
"These results are a stark reminder of the pressing need to boost the GP workforce. The number of GP training places per patient is well below the rest of the United Kingdom, meaning there aren't enough GPs coming into the workforce. The Welsh NHS needs to build a strong and resilient NHS workforce, including through the recruitment of GPs and other primary care professionals.
"This is not going to happen in time for this winter. It will likely be a trying time, both for those working in the NHS and patients trying to access services. We would strongly encourage patients to consider the variety of options available to them in primary care, making appropriate use of valuable NHS resources.
"The recent 'Choose Well' relaunch highlighted the effective role pharmacists can play in primary care. There are a number of other primary care healthcare professionals who can help patients and these all should be considered. NHS Direct Wales can be a valuable source of information, and we also need to see common sense approaches like at-risk groups receiving their flu vaccine."
She said: "Prescribing is a core skill for GPs, and we are highly-trained to make decisions about a patient's care based on their individual needs, in their best interests, and in conversation with them.
"For many patients with diabetes, medication is essential to help them manage their condition and live a good quality of life.
"But we also know that making straightforward lifestyle changes, for example, eating a healthy and balanced diet, losing weight and exercising more can prevent, delay, or sometimes even reverse Type 2 diabetes.
"GPs and our teams will have these often quite sensitive conversations with our patients, but our profession is currently operating under intense resource pressures and there is a limit to what we can realistically do within the constraints of the standard 10-minute consultation – and offering longer appointments means offering fewer appointments at a time when patients are already waiting too long to see their GP.
"Ultimately, we need to see the delivery of NHS England's GP Forward View, which promises an extra £2.4bn for general practice and 5,000 more GPs, as well as our additional ask of £2.5bn extra a year as part of the forthcoming NHS long-term plan, to ensure we can give more time to all of our patients, including those with diabetes."