Introduction

Primary care players in the UK have encountered a turbulent political and financial landscape since 2012, with a range of new pressures emerging. An inadequate supply of skilled professionals has combined with rising patient demand, inadequate facilities and funding issues.

New research from Deloitte UK Centre for Health Solutions examines these challenges while also raising concerns about how quickly key policy initiatives are being rolled out.

Primary Care today and tomorrow
 

With the existing primary care model at a tipping point, questions have begun to arise over the sustainability of the universal health service. But by taking a series of proactive steps, our report suggests the sector can evolve and adapt to the obstacles in its path to create a primary care model fit for the future.

Challenges facing primary care
 

The main pressures weighing on primary care include:

• Patient satisfaction: According to the British Social Attitudes survey, in 2015 overall satisfaction with GP services was 69 per cent, the lowest since reporting started in 1983
  
• Staff shortages: The number of full-time GPs dropped from 35,243 in 2010 to 34,055 last year, and up to 60% plan to leave over the next 5 years
  
• Wider workforce: Capacity issues in the nursing profession are having an impact on GPs. Recruitment drives for GP leaders and nurses are unlikely to meet the ambition by 2020
  
• Growing demand for GP consultations: Demand has grown by 10 to 15 per cent in the past five years
  
• Squeezed funding: The share of NHS spending allocated to general practice has dropped to 6.86% in 2015/16
  
• New policy initiatives: Sustainability and Transformation Plans have disruptive potential, but scale and speed of the process is large and ambitious, with little robust data supporting planning
  
• Estate investment: Only one quarter of GP practices across the country currently occupy modern purpose-built premises, despite many investment initiatives over the last 15 years.

Adapting to survive

In response to these threats, our report proposes the following:

• Securing adequate funding for general practice, equivalent to 10% or more of the overall healthcare budget.
• Strengthening the primary care estate and supporting the use of digital health technologies.
• Collecting better activity and performance data to enable adjusting reform process to outcomes.
• Developing proactive workforce strategies that improve recruitment and retention processes, while sharing responsibilities across departmental boundaries.
• Improving health literacy to increase citizen responsibility.