Fix investment in GPs and care, NHS warned

A FAILURE to properly invest in general practice and social care is one of the biggest policy blunders of the past 30 years, a report claims today.

The healthcare system in England must be ‘radically refocused’ away from hospitals if it is to be ‘effective and sustainable’.

The King’s Fund, a health thinktank which produced the report, argues officials should be putting primary and community services at the core. It highlights that the ‘vast majority’ of interactions with the NHS are with GPs, pharmacists and district nurses.

But taxpayers’ cash and staffing has been disproportionately directed to hospitals, leading to inefficiencies and delays.

The authors urge health chiefs to move more care ‘closer to home’ and stress that the ‘answer to over-crowded hospitals is not more hospitals’. They warn that patients who struggle to get appointments with their GP are at risk of having to seek urgent help from already over-stretched A&Es.

There are more than 876,164 GP appointments in the NHS every day, which is an increase of 34,219 since 2018-19. But despite this rise in demand – and repeated pledges to boost out-of-hospital care – the proportion of Department of Health spending on primary care has fallen from 8.9 per cent in 2015-16 to 8.1 per cent in 2021-22.

This has fuelled the daily 8am scramble for a GP appointment with general practice plummeting.

In 2021-22 the largest proportion of spending, £83.1billion, went to acute hospitals, while primary care received only £14.9billion.

The NHS has received additional money in recent years, but while acute hospital trusts have seen their funding grow by 27 per cent since 2016-17, community trusts have benefited from just half that level of growth, at 14 per cent. Trends in staffing reveal a similar pattern, with the number of NHS consultants growing by 18 per cent between 2016-17 and 2021-22, while the number of GPs has increased by just 4 per cent over the same period, the report says.

There has also been a significant jump in social care staff vacancies rising, from 110,000 in 2020-21 to 152,000 in 2022-23.

The researchers say progress has been hampered by ‘urgent challenges’ such as A&E waiting times and planned care backlogs, which are often the priority for politicians ‘tempted by quick fixes instead of fundamental improvement’. Sarah Woolnough, of The King’s Fund, said: ‘To achieve an effective and sustainable healthcare system, politicians need to radically refocus [the system] towards primary and community services.’

Lead author of the report Beccy Baird said: ‘Like other countries, England needs to bend the curve on the predicted rise in demand for high-cost and hospital-based care.’

Saffron Cordery, of NHS Providers, which represents NHS trusts, said care provided in the community ‘is too often overlooked when headlines and political priorities focus on a narrow set of acute-focused targets’. A Department of Health spokesman said: ‘This government wants to end short-term thinking and we are taking the longterm decisions that will mean everyone can access high-quality care.’

‘Too often overlooked’