MWord Issue 108 – Dr Michelle Drage’s latest update for GPs and practice teams

  • Mword

Covering: the NHS Long Term Workforce Plan, core funding as the key to retention and Londonwide LMCs elections.

7 July 2023

Dear Colleague,

  1. To retain us, we’re going to need a proper workforce plan – Restore. The. Core.
  2. Londonwide LMCs elections – reminder
  1. To retain us we’re going to need a proper workforce plan – Restore. The. Core.
    For the longest time I have been calling on Government, NHS England, ICBs and CCGs before them to do two things – invest in core general practice so that we can recruit and retain the GPs, GP nurses and practice staff that we all so desperately need; and trust us to do the job without being micro managed/forced to “assure” and jump through hoops in order to do so.

    So imagine the despair at Londonwide LMCs when the much lauded Workforce Plan was finally scheduled for release last week. We had hoped it would be a considered, consulted, costed, plan to tackle the escalating workforce crisis. One that would be welcomed by London’s hard-pressed general practice teams and our patients.

    Sadly, the politically motivated, unilaterally developed, largely unfunded announcement we finally received will do precious little to relieve the pressure on GPs or the frustration of patients right now, or in the medium term.

    I know that GPs in London are disappointed that neither the plan, nor the policymakers who drew it up, appear to understand the crucial role that GPs and practice teams play for patients and the NHS in terms of continuity, the management of multiple conditions, complexity and uncertainty. They choose to see us only as gatekeepers to other services doing tasks that can be hived off to others, and not experts in our own expert generalist biopsychosocial field.

    And because they do not see the value of this to the NHS, to patients and to communities they continue to configure the service as if it’s a roll-on roll-off conveyor belt of single, unconnected conditions to batch and dispatch as cheaply as possible. This fundamental misunderstanding worsens all the current problems relating to access and attrition, with the Workforce Plan’s lack of funding for core general practice doing nothing to reverse the decline.

    We know that demand for GP appointments is rising month-on-month.

    We know that despite greater appointment numbers than ever before, without new funding practices cannot recruit the workforce they need to meet the rising patient demand.

    We also know that we cannot just recruit our way out of the current workforce crisis; we have to also focus on retention.

    Until and unless politicians, policy makers and procurers recognise the importance of listening to the front line staff, any plan they draw up is unlikely to be worth the expensively printed paper it is written on.

    Our most experienced staff are our most valuable staff and are struggling to maintain safe care against a headwind of increased patient need and long-standing underfunding, 12-plus hour working days, increasing supervisory demands and scape-goating from the Government for waiting lists elsewhere in the system.

    Training more GPs and other supporting roles does not recognise that retention is the biggest issue right now. Reducing GP training time is a false economy, as newly qualified GPs will need more support from experience colleagues, drawing them away from patient care. And the expectation that GPs have the time to supervise growing numbers of pharmacists, physiotherapists and other roles which have been worked into the general practice team over recent years is unrealistic.

    We need autonomy and resources restored to the core general practice team. And unless we want to see further decline of general practice as we know it as chunks are removed bite by bite … we’re going to need a proper plan for general practice.

    So here’s one I wrote earlier:

    To retain us, Restore. The. Core.

  1. Londonwide LMCs elections – reminder
    I’ll finish with a reminder – only LMCs represent local grassroots GPs and are not influenced by funding from commissioners or other arms of government.

    At a time when GPs and practice staff across London need a strong professional voice more than ever, amid here today and gone tomorrow NHS bodies, LMCs offer stability, continuity and independent expertise across all aspects of general practice – by general practice, for general practice – from engaging with systems across London to supporting individual GPs, and everything in between.

    More than half our LMCs now have their places filled for 2023, and the remaining areas had ballot papers emailed out to constituent GPs last week, on Monday 26 June. If you are unsure if your area is going to ballot please check your inbox to see if you have electronic voting papers emailed to you by Civica Electoral Services via This email may have gone to your junk/spam box, so please check there as well.

As ever, I welcome your feedback at

With best wishes




Dr Michelle Drage MBBS FRCGP
CEO, Londonwide LMCs