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04-12-2012 | General practice | Article

London GPs face calls for drastic change


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medwireNews: The King's Fund has called for major reorganisation of primary care and the way it is delivered in London, saying the capital faces unique challenges in the years ahead.

Despite some areas of excellent performance, the Fund argues that Londoners report low satisfaction with their GP services, in particular for access to and quality of consultations and for support for long-term conditions.

In a report out this afternoon, policy advisors say that some practices are continuing to operate from premises that "are not fit for purpose", while the workforce in London is older than elsewhere, with a quarter of GPs aged over 60 years in some areas, and the proportion of single-handed practices is also higher than across the rest of England.

They urge GPs to work more closely with hospitals and community services and social care, to make better use of data to cut local variations in performance and to move towards different models of service provision - such as federations and networks - to broaden the number of services delivered by small practices.

Londonwide LMCs issued an immediate rebuttal of the report's recommendations, however. Welcoming a focus on the specific challenges in London and the positive health outcomes achieved in spite of these, they nevertheless say that the report's repeated comparisons with the rest of England are "inappropriate and misleading".

Instead of "radical model redesigns", they argue for building on the "successful model we have", and that a modest increase in the percentage of the funds allocated to general practice could make "a huge difference".

"What general practice in London really needs, and what patients deserve, is growth in the recruitment of GPs and practice nurses, better staff training, incentives to work collaboratively together and with other services in the community, and essential improvements to existing premises," they write.

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Caroline Price, Senior medwireNews Reporter