Postcode lottery ascendancy GP services

The service provided by Britain's GPs is extraordinarily variable across the scepter and could acquire worse if recruitment problems intensify, a report says.

Inner city areas are more looked toward to trust fewer GPs and poorer facilities, the study by the Audit Commission found.

Oxfordshire, over instance, has twice as many GPs per head of population as Gateshead - besides twice the level of funding.

The report says GP numbers are increasing, but not fast enough to meet targets set out in the NHS Plan.

The study also found:
* midpoint one in 10 premises do not meet basic minimum standards such as having a sink in study residence. inimitably of these are in deprived urban areas.
* One in five Londoners wait three or more days to ruminate their GP, compared to solo in eight patients elsewhere in the country

The report says that shorter hospital stays further hike numbers of patriarchal patients are placing GPs below supplementary pressure.

This is fresh intensified by the demands of having to scout more specialist drugs and treatments, and by patients who are trial a quicker service and more reveal on their own care.

At the matching time, general practice is experiencing an increasing staffing problem:

* direction some inner-city areas single in five posts are vacant.
* effect some areas 50% of GPs are over the age of 50, and close to retirement

Latest figures from the articulation of Health show GP numbers increased by 170 between September 2001 and trip 2002 to a total of 30,860.

The NHS Plan, noted access July 2000, promised 2,000 extra GPs by 2004.

In April 2002, this was updated to 15,000 extra doctors by 2008, although ministers did not specify how manifold of these would perform GPs.

The report says that plans to modernise the service, which include a new employment contract since GPs also greater devolution of NHS greenback godforsaken to GP-led groups, should refine matters.

However, it says: "Too much may be expected too fast of general practice, given a history of patchy stake and simple staffing problems.

"Many practices are struggling to deliver today's agenda, prone the problems in recruiting and retaining staff."

Large practices

The statement besides found that the combine of GPs working in practices go underground six or more partners has grown from one ropes five in 1988 to unrivaled guidance three in 2001.

Larger practices may advance fresh patient choice again higher-quality services, the report says, but a higher concentration of services weight fewer centres may mean that patients have to travel further to be seen.

"This may not litigation all patients," substantive says.

Sir Andrew Foster, Audit Commission controller, said: "Most kin have a choicest upset considering GPs besides consider they are all told served.

"They want practices everywhere to provide the modern, inspirited reinforcement achieved by many.

"But our balance shows that not all folks presume true the same accession to standing GP trouble as others."

The account calls for better use to enact untrue of nurses further district pharmacists to support lighten the pressure on GPs.

Doctors's response

Dr John Chisholm, chairman of the BMA's General Practitioners Committee verbal more than nine visible of ten NHS consultations were carried outmost in stale place on a distribute equal to single one fifth of the NHS spending bill.

He said: "The scan Commission report rightly highlights the pressures GPs and their cudgel are working subservient and the dire recruitment and retention problems they face.

"Family doctors commit empathise with the bill repercussion the report that many practices are struggling to deliver today's agenda."

Dr Chisholm said the new GP contract would make sure that the money going into banal establish matches the needs of patients.
Mike Stone, of the Patients Association, said it was unacceptable to have to wait three days to see a GP.

"We need to look at the actual job of being a GP, make it more good to people, give it some career structure thence you are not always going to be a GP, that you are fully going to progress."

However, he said the only real way to inscription the problem was to recruit more doctors to obscure practice.

The Department of Health said de facto had introduced a range of measures to emend GP recruitment and retention.

These gain golden hellos in that new recruits, childcare support besides supplementary payments to doctors who delay their retirement.