General Practice: At Capacity, Yet Capable of More
General practice is the bedrock of the NHS, handling over 90% of patient interactions while receiving less than 10% of the NHS budget. Yet despite its pivotal role, GP services are at breaking point. Practices are operating at full capacity, with increasing demand, workforce shortages and administrative burdens placing an ever-growing strain on the system.
However, despite these pressures, general practice has the potential to deliver more. With the right funding, resources and structural support, it could expand its capacity, improve patient care and play a greater role in reducing pressures elsewhere in the healthcare system.
Why General Practice is at Capacity
Unprecedented Demand Growth
The demand for GP services has risen dramatically in recent years. An ageing population means more people are living with long-term conditions that require ongoing management. The complexity of patient care has also increased, with multimorbidity, mental health issues and social care needs often requiring longer consultations.
At the same time, delays and bottlenecks in secondary care have shifted additional responsibilities onto general practice. Patients waiting months or even years for specialist treatment return to their GPs for support in the meantime. Hospitals regularly ask GPs to prescribe hospital-initiated medications, issue sick notes and chase referrals—tasks that should be the responsibility of secondary care.
Workforce Shortages
Despite repeated government pledges to increase GP numbers, recruitment has not kept pace with demand. The profession is struggling to attract new doctors, with many junior doctors deterred by the intensity of the workload and the level of bureaucracy.
High attrition rates among experienced GPs are also a major concern. Many are reducing their hours or leaving the profession altogether due to burnout, stress and the growing burden of administrative work. A lack of investment in training and retention strategies has further compounded the problem, with GP practices unable to recruit enough staff to meet patient needs.
Administrative Overload
GPs now spend a significant portion of their time on administrative tasks rather than patient care. The volume of paperwork has become overwhelming, with excessive referral forms, medication authorisations and reporting requirements adding to the burden.
Much of this work is a result of secondary care shifting responsibilities onto GPs. Tasks such as reauthorising prescriptions started by hospital specialists, providing fit notes for patients under hospital care and handling follow-up requests should not fall within the remit of general practice. The inefficiencies of NHS IT systems only make matters worse, forcing GPs to duplicate work and manually enter data across multiple platforms.
Underfunding and Outdated Funding Models
Despite its critical role in patient care, general practice remains underfunded. It receives a disproportionately small share of the NHS budget compared to secondary care, even though the vast majority of patient interactions take place in GP surgeries.
Current funding models do not adequately reflect the complexity or intensity of modern general practice. The national contract is outdated and does not incentivise innovative ways of working that could increase efficiency. Many practices are also struggling with rising costs, making it difficult to invest in additional staff, technology or premises improvements.
How General Practice Could Deliver More with Proper Support
Investment in Workforce Expansion
A properly funded workforce strategy could help reverse the decline in GP numbers. Retention schemes, fairer pay and workload management would help prevent burnout and make general practice a more attractive career choice.
Expanding multidisciplinary teams would also relieve pressure on GPs, with additional advanced clinical practitioners, pharmacists, paramedics, physiotherapists and mental health practitioners able to handle specific patient needs more effectively. Investment in practice nurses and healthcare assistants would further increase capacity by allowing more routine care to be managed within primary care.
Reducing Bureaucracy
Unnecessary administrative work must be removed to free up GP time for patient care. Hospitals should be required to take responsibility for their own prescriptions, fit notes and follow-up arrangements, rather than passing these tasks on to GPs.
Better IT solutions could also help reduce duplication and improve efficiency. Fully integrated systems would allow primary and secondary care to communicate more effectively, eliminating the need for GPs to repeatedly input patient data or chase missing information.
Increased Funding and Reform of Payment Models
A greater share of NHS funding must be allocated to general practice to reflect its role as the frontline of healthcare. Funding should be linked to workload and patient complexity, rather than simply being based on a headcount.
Investment in primary care infrastructure is also essential. Many GP premises are outdated and unsuitable for the demands of modern healthcare, limiting the ability of practices to expand services. Additional funding for digital tools, workforce training and staff wellbeing would help ensure that general practice remains sustainable in the long term.
Better Integration Between Primary and Secondary Care
A more collaborative approach between primary and secondary care would help to ease pressures across the healthcare system. Clearer pathways should be developed to ensure that patients receive the right care at the right time, without unnecessary delays or repeated visits to their GP.
Hospitals and community services must take greater responsibility for their patients, rather than relying on general practice to fill the gaps. Shared responsibility agreements and better communication channels would help to streamline care and reduce unnecessary workload for GPs.
Embracing Technology and Innovation
Digital solutions could help free up GP capacity and improve access to care. Remote consultations and digital triage, where clinically appropriate, could reduce unnecessary face-to-face appointments and allow GPs to prioritise urgent cases more effectively.
Artificial intelligence and automation could also help with administrative tasks, such as appointment booking, documentation and coding. Investment in shared care records would improve communication between GPs, hospitals and community services, ensuring that patients receive more joined-up care.
Conclusion: The Potential of General Practice
General practice may be at capacity, but that does not mean it cannot deliver more. With the right funding, smarter working practices and a reduction in bureaucracy, it could become even more efficient, accessible and effective.
For patients, this would mean faster access to care and better health outcomes. For commissioners, it would create a more cost-effective and sustainable healthcare system. For governments, it would support the long-term stability of the NHS and ensure that primary care remains the foundation of community healthcare.
The solution is clear: invest in general practice, and it will deliver. Now is the time for action.