Update 18 March 2025:
Following the meeting, Bell Ribiero-Addy wrote to the Department of Health and Social Care to ask:
And to ask what assessment has he made of the:
- adequacy of the Carr-Hill Formula in areas with high levels of deprivation?
- adequacy of the mechanisms in place for ICB’s to hold Swift Queue to account for faulty services?
- number of registered GPs not in employment, and what steps is he taking to address this?
- national insurance contribution increase on GPs?
- adequacy of the ARRS?
Original text:
The meeting was subsequently featured in Bell Ribiero-Addy’s newsletter to her constituents in Clapham and Brixton Hill .
Representing local general practice were:
- Dr Penelope Jarrett, Chair, Lambeth LMC.
- Dr Azhar Ala, Lambeth LMC member and partner at Grafton Square.
- Christina Bourton, care co-ordinator at Grafton Square.
The discussion covered:
Workforce
- Lack of investment in core funding means practices are not able to employ enough GPs, with a substantial proportion of this year’s uplift due to go in increased employers’ national insurance contributions. The funding formula also fails to adequately account for the effects of economic deprivation.
- Current pressures in terms of workload and burnout mean the profession is not retaining GPs who are being trained.
- Practices would be able to provide more GP appointments if extra investment over recent years was not tied up in the restrictions that come with ARRS. Colleagues employed through ARRS are useful, but practices would prefer to the freedom to employ the skill mix they feel is best able to meet their patient population’s needs.
- Adding GPs to ARRS temporarily has not made much difference due to the strict criteria attached to employing them via this route.
Access
- Practices have been very successful in offering increased numbers of appointments, but this does not mean they have increased capacity.
- Bell Ribiero-Addy raised the fact that digital access is not right for every patient, including her own experience, and that many feel pushed to use it. The GPs explained that they are subject to targets associated with it and that funding has remained static as usage has grown.
- She also spoke about her relationship with her GP while growing up. This doctor was known to Dr Ala and provided an opportunity for the GPs to emphasise the value of continuity and relationships in providing good quality care.
- Integration and collaboration
- Lack of space in estates and difficulties with landlords, including NHS Property Services, are a hindrance to bringing other services together with general practice.
- Reciprocal arrangements that used to cover practices on the boundaries of different commissioning areas have been lost, affecting patients who live near where one ICB borders another.
Next steps
- The GPs suggested that improving working across NHS geographical boundaries is something an MP could help with.
- In terms of national policy, it would help to a precise number of how many GPs have been recruited in Lambeth via ARRS and have some idea of what proportion of additional funding would be taken up by the NICs rise.
