London general: 70 years of improving life in the Capital
NHS general practice is celebrating its 70th birthday, which is a major milestone in the history of British medicine. The availability of general practice to Londoners (8m of us in 1948, 9m now, but as few as 6.5m in the 1990s) has been the bedrock of the NHS since its founding, providing cradle-to-grave care to all families, including those in the most deprived communities.
With 90% of NHS contacts taking place in general practice, GPs and practice teams are the face of the NHS throughout the Capital. Recently the Government announced a £20bn investment in the NHS, but from past experience little of this will reach the frontline of general practice. It is likely to be, as with much of our history, the hard work and dedication of the whole team working inside each GP surgery that delivers the next 70 years’ of success. So, on this significant birthday I would like to reflect on what general practice has achieved.
Universal coverage
Thanks to the development of NHS general practice, more and more people are now in regular contact with their GP:
-
91% of patients trust their doctor, with doctors and nurses being the two most trusted professions in the UK; and
-
84% of patients are very satisfied with their GP.
Eradicating disease
Before the NHS many people were dying from preventable ailments such as diphtheria or tetanus. Today the children have access to universal vaccination programmes, delivered by general practice:
-
125,000 children are born in London each year, all have access to vaccinations from their GP;
-
polio was officially eradicated in the UK in 1988, following three decades of vaccination work; and
Longer lives
Average lifespans have grown substantially since 1948, with the work of general practice meaning far more people are living decades beyond retirement age:
-
today 65-74 year olds represent 51% of pensioners and over-85s now represent 14%;
-
general practice is still fighting to close the lifespan gap between rich and poor, with people in Kensington and Chelsea still living on average four years longer than those in Tower Hamlets.
A diverse workforce
Over the past 70 years, the NHS has transformed into being among the most diverse workforces in the world, currently a quarter of NHS staff working in London are from outside the UK and general practice draws its talent from across the globe:
-
764 qualified in the Europe Economic Area;
-
3,434 GPs qualified elsewhere in the world; and
-
48% of registered GPs and men and 52% women.
The enduring role of the family doctor
These achievements are impressive and a testament to the way general practice has developed with the NHS, but the values of general practice have rightly remained the same. A report from 1948, titled Public Health in 1948: Remarkable Statistics: the first months of the National Health Service paints a picture that GPs and practice teams would recognise today, although now we do have equal numbers of “his” and “hers”:
“The success of the family doctor service depends primarily on the family doctor's relationship with his patients and that is not changed merely by an alteration in the method of payment for service. The administration required is far less than in the other branches. The service has been extremely popular with the public and it seems that despite the size of the undertaking and despite the uneven distribution of load which follows from the present distribution of doctors, the family doctors carried it successfully through its first year.”
The clinical team is made up of GPs, nurses, advanced practitioners, healthcare assistants and numerous new roles delivers so much more than the sum of its parts. Triaging, advice on self-care, diabetes management and many other tasks have been passed from GPs to skilled colleagues. The support they received from practice managers, administrators and reception staff enables the clinical team to take on these wider roles and helps to relieve much of the bureaucratic load which the powers-that-be choose to impose.
Last updated : 05 Jul 2018
Covid-19 antiviral pilots (16 Dec 2021)
The government announced this month that thousands of the UK’s most vulnerable people will be among the first in the world to access a new antiviral treatment for Covid-19, Molnupiravir....Registering overseas vaccinations at vaccination sites (16 Dec 2021)
On 9 December the Government updated guidance advising patients who wish to add an overseas Covid-19 vaccination to their NHS record to do so by booking a specific type of...Guidance updates December 2021 (16 Dec 2021)
The most important pieces of guidance released for general practice since our last newsletter are: Regulatory approval of Pfizer/BioNTech vaccine for COVID-19 and Regulatory approval of Spikevax...PCSE updates on contact details and pooled lists (16 Dec 2021)
Correct contact details Practices can improve communications with PCSE by ensuring that they have the most up to date practice contact details, including: The main practice contact All user...MP engagement and government consultations (16 Dec 2021)
During late November and December 2021 representatives from Londonwide LMCs have continued to meet with MPs, councillors and the police to raise issues affecting practices. We have also submitted evidence...Tips of the month December 2021 (16 Dec 2021)
We provide weekly tips based on common queries which come through to us from London GPs and practice teams. These are shared via social media and collated for...Dr Michelle Drage’s Christmas and New Year message (16 Dec 2021)
Thank you for simply still being here after the year you and all London general practices have had. With relentless pressure coming from clinically necessary activity, and the equally relentless...Annual General Meeting for Londonwide LMCs and Londonwide Enterprise Ltd (16 Dec 2021)
The Annual General Meeting for Londonwide LMCs and Londonwide Enterprise Ltd will be held on Thursday 20 January 2022 between 2:00pm and 3.15pm. The AGM is a chance to meet...Londonwide LMCs' December 2021 Newsletter (16 Dec 2021)
Guidance
We provide expert guidance for practices in our guidance section, as well as an archive of other materials you may find useful.
GP Support
Contact our GP Support team if you need help or advice.
The team provide professional and pastoral support to GPs and practice teams on a broad range of issues.