How much longer can primary care workers weather this perfect storm?


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By Gemma Collins
Group editor, Cogora

27 Mar 2019

The pressures on primary care workers have little chance of easing up any time soon, says Gemma Collins – group editor of The Pharmacist’s parent company Cogora

We have seen little improvement in the state of primary care over the past year; the ever-increasing patient demand against a backdrop of dwindling GP numbers and fewer nurses continues to result in rising workloads, early retirements and practice closures.

If anything, the sector is facing greater pressure than ever, as the Government shifts its focus more and more onto primary care to help move patient care out of hospitals and into the community. But how equipped is primary care to deliver this shift?

Cogora’s Primary Concerns survey has always been able to capture the opinions of those who know the sector the best. And for the 2018 survey, our sixth to date, we have focused more on the real issues concerning our readers. The wide reach of our five publications means we can capture the opinions of a range of healthcare professionals, from the decision makers – GP partners and practice managers – to salaried GPs, practice nurses and healthcare assistants, as well as district and community nurses, working hard on the ground to deliver high-quality care.

But this doesn’t present the full picture. For the first time, we have included community pharmacists in our findings, to gather first-hand evidence of how recent funding cuts are affecting the profession, the financial impact of medicine shortages and how much of their day is spent chasing out-of-stock medicines.

In addition, Cogora’s unique position of writing for both a community pharmacy and a GP audience has enabled us to gather evidence of what the two professions really think of each other. Our publications have reported on the rivalry between the two professions, particularly with last year’s ‘flu wars’, but for the first time, we can reveal whether they really do see each other as a financial threat when it comes to the provision of NHS services.

The findings of the past five surveys have indicated low levels of morale across primary care. Our previous survey revealed that the factors impacting on morale included feeling overworked, experiencing too much bureaucracy and feeling under-appreciated by NHS management. We decided this year to drill down into these specific factors.

We asked employees how often they were working unpaid beyond their contracted hours and whether they had asked for a pay rise in the past 12 months and been successful in their request. And for the decision makers, we quizzed them about the specific cutbacks and concessions they had made or considered during 2018, and whether full-blown closures were on the cards. And for what could be the starkest indication of a sector in despair, we can reveal how big a proportion of respondents are considering quitting primary care altogether.

Our findings don’t make for positive reading, but they do offer a genuine picture of the current state of primary care. Since we surveyed our readers, NHS England has published its Long-Term Plan, which promised an £4.5bn funding boost for primary care. This was then followed by the announcement at the end of January of the new GP contract, which has been touted as the ‘most significant’ contract in 15 years.

They both perhaps signify the Government’s decision to prioritise investment in general practice and community care and could be the recognition that the sector has been waiting for. Could these developments be the key to a happier primary care workforce? We’ll have to wait until our 2019 survey for the answer.

Read the full report here

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