Like the rest of our NHS, London’s model for GP services hit seventy this year. Seventy is a good time for anyone to reflect on the past and think about the future. The need for taking stock has taken on extra importance this week, with the recent publication of the latest patient satisfaction survey. Over 125,000 Londoners have engaged with it and told us what they think of the care they receive from their GP.
It is clear from the survey, that Londoners, like the rest the country, rate their GP service highly. They know what the GP is there for, they are generally aware of how to get an appointment, and they trust their GP to listen. Indeed, as the nature of our patients and their illnesses change, GPs are becoming more central to healthcare.
As a practicing GP myself I am constantly reminded of how the role has changed since I qualified. We now see many more patients, who tend to be older and have more complex conditions. One in five people surveyed had a problem getting about, had suffered multiple falls, or felt socially isolated. Two in five Londoners who go to see their GP had a long-term health condition like high blood pressure, diabetes, or arthritis.
On the other hand, with more people moving, or using new services like GP at Hand, there are many patients I will see once and then not again. It is against this backdrop that the NHS, and the Mayor of London, as Chair of the London Health Board, need to make sure GP practice is fit for the next seventy years. Over a quarter of London’s GPs are due to retire soon, more than any other part of the country. The NHS has grown up around their careers and as they move on, so will the system.
This is an opportunity to correct and smooth-out the inequalities in our GP service across the capital. Although GPs are ever more aware of mental health conditions, there are areas of the city, particularly in South London, where one in ten patients feels their mental health needs are not understood. There is also disparity amongst in the boroughs in that twice as many people in Barking and Dagenham, Newham and Redbridge say they had a poor experience with their GP than in Sutton.
In addition, patients’ expectations of what their GP can do for them can also tend to diverge.
We must recognise that though people like knowing they can visit their GP, the doctor cannot make increasingly common chronic conditions go away. In almost half of boroughs, at least one in five people do not feel they get the support they need to manage their conditions. GPs need to be linked into well-funded health, community and social services to best serve patients.
Otherwise, the numbers of people attending their GPs will keep going up, putting more pressure on doctors who are already under significant strain. Worse still, these people will leave perhaps feeling better for having seen someone, but no closer to getting the support they need to live as well as possible.
London comes out slightly worse in this survey than the national average, so there is clearly room to improve. In the London Assembly’s Health Committee, we have been scrutinising the Mayor’s Health Inequalities Strategy and look forward to it reducing London’s health gap. However, with changes already happening in the capital’s health sector, now is the time for the Mayor to lead health partners in a discussion about how we build a GP service that fights inequalities, attracts new doctors, and makes London the healthiest city in the world.