Agenda item

Dr Caroline Rickard, Medical Director, Kent Local Medical Committee was in attendance for this item.

1.    Dr Caroline Rickard (Medical Director, Kent Local Medical Committee) introduced herself. She said that she worked as a GP two days a week and was a Medical Director of the Kent Local Medical Committee (LMC). Two of her colleagues were also Medical Directors at the Kent LMC. The organisation had a committee of 40 elected GP representatives and had a statutory duty to represent all GPs across Kent and Medway. The organisation was funded directly by practices through a statutory and national levy.

2.    Dr Rickard presented her report. She said that general practice funding was quite complex, and there had been some inherent issues with the way that it was calculated nationally. The reason why the Car-Hill formula was called for widely for reform was because the way it was calculated did not adjust for deprivation effectively and accurately. This had led to practices in the most deprived areas having almost 10% less funding than those in the least deprived areas.

3.    The Car-Hill formula was developed in 2002. Since then, there had been the digitization of GPs records which had led to a much greater understanding of the impact of deprivation on the local population’s health. The impact of the loss of funding as a result of the adoption of this formula was that GP practices were closing.

4.    The local population had been increasing and the number of GPs has not kept up. In Kent, there was an average of one full-time equivalent GP to 2 ,702 patients. National data suggested that 142 more full-time GPs were needed to meet effectively the demand in Kent and Medway.

5.    The impact was not just about patients’ visits; GP’s practice workload involved also checking patient's results, examining hospital letters, ensuring that the prescriptions were signed and that they were correct, and producing medication reviews.

6.    According to a Kent LMC’s survey of local GP practices in 2023, GPs reported that they were feeling more stressed as a result of this increased pressure. GPs and contractors were all working significantly above their core contracted hours.

7.    This was not just a trend in Kent and Medway. Nationally, 60% of GPs had reported significant stress, and 30 % of practices had ceased recruitment due to financial uncertainty. So practices had to cease recruiting because they did not have enough core funding to be able to recruit sufficient staff.

8.    Dr Rickard said that the GP practices that they represented were advocating for a guaranteed, long-term funding plan for general practice that would give them assurance that they could recruit staff.

9.    The ten-year plan outlined the shift from hospital to community, and GP practices were already very experienced at delivering hospital-type care. They already delivered dermatology and urology services, cardiology clinics, eye surgeries and eye clinics. For every pound that was spent in community or primary care, there was up to a £14 return into the economy.

10.In order to keep that continuity of care, investment in core general practice was needed so that newly recruited GPs could be retained.

11.In answer to a question about whether local GP practices were using AI, Dr Rickard said that GP practices were already using digital tools in a number of ways. AI Scribe typed up the consultation automatically and enabled GPs to listen to the recording. Online consultations would become another point of access to general practices.

12.A Member asked how the plan for GPs to cover larger areas would reconcile with the current model.

a.       Dr Rickard replied that it was essential that general practices were equipped so that they could provide their services to wider areas. It was crucial to support them so that they could recruit GPs into long-term posts.

13.A Member asked Dr Rickard to comment on the impact of the national insurance annual increase of £38,000 for the average practice.

a.       Dr Rickard replied that GP practices were small businesses, and such an increase would have a significant, negative impact on them.

14.A Member asked Dr Rickard whether she knew if becoming a GP was still a good career choice for young people.

a.       Dr Rickard said that many young people were still choosing this profession. However, she cautioned that, nowadays, newly qualified doctors would look for job opportunities in the global market. Also, aside their salary, their working conditions and work-life balance were also important to them.

15.The Chair thanked Dr Rickard for her informative presentation and for answering questions.

16.RESOLVED that the Committee consider and note the report.