General practice is well used and it is one of the most popular public services. Almost all the population is registered with a general practitioner (GP) and it represents eight out of ten patient contacts with the NHS. Most public surveys show satisfaction levels at around 80 per cent. General practice is also at the forefront of the Government's plan for modernising the NHS and more is now being expected of GPs and practice nurses in their day-to-day work. General practice has undergone considerable change in the last ten years and has adapted well. But there are some structural barriers, and some pockets of poor practice, that may prevent all patients getting the service they deserve.
This report reviews evidence on general practice in England, highlighting current strengths and weaknesses. It uses published evidence and also makes use of data sources that may not be widely known, such as a database of all practices in England, surveys carried out of patients at more than 400 practices and nursing membership information. The Audit Commission did not itself collect data for this study, but did hold some focus groups of GPs to better understand the reported problems of low morale in the profession and the reality of working lives in general practice. This report does not cover Wales, as some data sources were for England only and, while many issues are common to both countries, there are some distinct concerns for Wales.
This report aims to provide a baseline of evidence at a time of great change, with a new contract for GPs under negotiation, national standards for clinical care and greater powers given to primary care trusts (PCTs) to shape general practice. At such a time of change, it is important that the strengths of general practice are retained, while allowing for improvements.
This report will be followed by a more detailed review next year, which will help PCTs to shape general practice. It may include areas such as information systems, premises, team working and practice management. The Audit Commission will also be publishing later this year reports on general dental services and PCTs, as part of a programme of work on primary care.
Included in this report:
- quality and service provision
- pressures, demands and workload
- resources and supply