Two-thirds of practice managers said sustainability and transformation fund (STF) allocations had brought ‘no improvement’ to general practice, a report has revealed.
The Primary Concerns 2018: The State of Primary Care report, published last month (27 March), surveyed the readers of Cogora’s five primary care publications: Management in Practice, Healthcare Leader, Nursing in Practice, Pulse and The Pharmacist.
In addition to practice managers, the report also gathered responses from GP partners, salaried GPs, pharmacists, healthcare assistants and nurses.
NHS England recommended that sustainability and transformation partnerships (STPs) allocate 15-20% of their funds to general practice from 2016.
While 66% of practice manager respondents said they had seen ‘no improvement’ as a result of this, 20% reported ‘some improvement’ compared with just 6% of GPs.
‘More work for no gain’
One anonymous practice manager respondent said: ‘Alliances and STPs are a talking shop and not having a direct impact on primary care – except more work for no gain.’
As many as 40% said the implementation of STPs had had a neutral effect on the quality of patient care in the previous year.
Only 0.8% believed their impact has been ‘extremely positive’ and a quarter, 25%, said it had been ‘negative’ or ‘extremely negative’, compared with 0.23% and 31% of GPs respectively.
‘A huge negative impact’
Nearly a third, 31%, of practice managers also believed the up-scaling of primary care and large-scale GP practice organisations had had a ‘negative’ or ‘extremely negative’ impact on the quality of patient care in the previous 12 months.
GPs were even less enthusiastic, with 43% agreeing with this assessment.
Working at scale has been a focus of the NHS long-term plan and new GP contract, both published in January, with NHS England announcing plans for practices to join primary care networks across England by July 2019, backed by £1.8 billion of funding by 2023.
Another practice manager said: ‘The push to gear all funding and working practices towards large superpractices is having a huge negative impact on the many good and hard-working small practices.’
Almost four in 10 practice managers, 38%, and 31% of GPs thought working at scale had a neutral impact on patient care.
The NHS ‘a political football’
The majority of practice managers, 58%, believed the General Practice Forward View had brought ‘no improvements’ to the sector since its announcement in April 2016.
Almost a third, 31%, acknowledged it had brought ‘some improvements’ to primary care services, the highest figure among respondents.
The report also revealed that as many as 47% of practice managers said they were considering leaving the profession in the next year.
When asked their reasons for wanting to leave, one practice manager said: ‘I’ve simply had enough of the never-ending change. The NHS as a political football is not sustainable. We need stability NOT constant improvement plans and initiatives.’
