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Lincolnshire GP service could be pushed into the ‘abyss’ if more funding isn’t found, expert warns

Lincolnshire faces a healthcare funding crisis that could push the already strained GP sector into the abyss if more money isn’t made available, a serving GP and medical expert has warned councillors.

Dr Reid Baker, the Medical Director of the Lincolnshire Local Medical Committee, said that despite the hard work of those within the sector, the current model of practice is “under a lot of pressure” and “not viable” unless circumstances around funding and demand change.

Alarming statistics around Lincolnshire’s levels of GP provision were revealed at the county’s monthly Health Scrutiny Committee meeting on Wednesday, May 15.

Dr Reid Baker. Photo: LDR
Dr Reid Baker. Photo: LDR

General Practices provide 92% of first patient contacts across NHS England, but are given just 6% of the overall funding package for national healthcare. Dr Baker argues GPs need “at least double that” to fulfil the demand of patient care.

This, among other factors, has resulted in a major dilemma for the sector to address.

Those factors include a 25.5% shortfall across the last five years to boost funding in line with national minimum wage increases, a 20% reduction in the number of practices in Lincolnshire over the last decade, and there being just 0.44 fully qualified GPs per 100,000 people in the county.

Dr Baker said Lincolnshire’s ageing population created a “multi-faceted” issue for the county’s health sector.

“We’ve got an increasing population, an increasing elderly population with a lot more medical conditions, and that is increasingly challenging in this environment, particularly around recruitment and retention of GPs and GP colleagues.

“The financial challenges of the new GP contract has left us with yet another less than real term rise, which actually gives us a 20% reduction in GP funding over the last 7-8 years, while we’re actually doing about 20% more work than we ever were.

“We’re trying to do all that we can, but the pressures are mounting, and that’s difficult for all our colleagues as well as the patients themselves.”

Coun Tom Smith (Conservative) asked if the system in place for GPs was “workable” in its present form, saying the county is at risk of a “domino effect” in which GPs collapse under the weight of demand and therefore pass on patients to other practices across the county.

He argued that “more and more GPs” are looking to move towards a fixed salary model rather than working in partnership, and said GPs are not alone in their desires for more money.

“There are a number of things that deeply concern me,” he told the committee. “The report says more taxpayer money is needed and, well, I’ll be blunt and say that isn’t really an option.

“Money doesn’t grow on trees and the NHS allocation as a whole has been protected for years. As local government we are responsible for adult social care, and the NHS is going to have a world of pain on its hands if we suddenly say we can’t deal with it anymore.

“So to say we need more money please, again I’ll be blunt, get in line because we all do!”

This was challenged by Coun Charmaine Morgan (Democratic Independent Group) who felt the sector was “on the edge of being unsustainable” and argued funding levels for the wider NHS was a “political decision.”

Chair of the Health Scrutiny Committee, Coun Carl Macey (Conservative) commented that he felt Lincolnshire’s health sector was “one of the worst funded in the country” during this debate.

Dr Baker said of the funding pressures that it is both a local and national problem, and hopes to get “proper, above inflation funding” for the health sector and particularly GP provision, as a long-term solution.

“The last thing we want is to see the practices struggling and then the patients struggling to get the care they need, so if we can all work together, we can try to support the GPs, because they are the bedrock of the NHS.”

Questions were also asked of the standards upheld at GP practices, as Coun Richard Cleaver (Democratic Independent Group) expressed concern over the CQC ratings of some health settings in Lincolnshire, with over 100 rated inadequate.

There are currently two Lincolnshire GP practices — Caskgate Street Surgery in Gainsborough and Sidings Medical Practice, Boston — rated inadequate, and a further six rated require improvement.

The county has a total of 81 GP practices, meaning that just shy of 10% of Lincolnshire’s practices fall below the standards of the Care Quality Commission, and the eight in question care for around 116,000 patients — which is 14.2% of the eligible population.

Coun Cleaver expressed fears of a “slow drip effect” in which the number of these practices needing improvements rises, citing that three of the four CQC inspections at Lincolnshire GP practices this year have brought back scores of requires improvement.

Dr Baker, a GP in Woodhall Spa, called it a “reflection of the pressures” on the sector at present, and argued that access to greater resources and staffing would breed “much different outcomes” when it comes to CQC grading.

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