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The way GP practices work ‘needs a culture change’, says health secretary

Health secretary Matt Hancock has suggested that his future vision for primary care will be to increase the number of practice nurses and ‘change the culture’ of how GP practices operate.

During a health select committee meeting, he was asked about his work on primary care and his efforts to recruit 5,000 more GPs by 2020.

When it was put to Mr Hancock that there has been a net loss of 1,000 GPs, despite boosts to recruitment, he claimed that there were methods to improve primary care ‘through different ways of working within GP surgeries’, as well as by recruiting more GPs.

He said: ‘It struck me when I was looking at the initial analysis of the NHS workforce that in an acute setting, on average, there are twice as many nurses as doctors. But in primary care there are typically twice as many doctors as nurses.

‘Now a difference might be appropriate because they are different settings, but I know that there are many GP surgeries that are moving to having more of a structure whereby the GPs only see cases that a GP can see, and there are more nurse practitioners and other staff for the rest. So that direction of travel is really important. That doesn’t mitigate the fact that we need more people in primary care, but we also need a culture change in the way our GP practices work.’

But he refuted the suggestion that the recent doubling of the GP practice pay uplift to 2% would not be enough to stop practice nurses leaving primary care for hospitals, due to Agenda for Change pay negotiations producing a better pay increase.

He said: ‘We’ve already started discussions on a longer-term settlement that can also include changes to the GP contract. So I regard this as a first step. But there’s a much wider conversation to be had’.

Last week, it was announced that GP practices would receive an additional 1% uplift, on top of the 1% announced in March, to help pay for salary increases of practice staff. But this was well below the 4% recommended by the Review Board for Doctors' and Dentists' Remuneration.