The Institute of General Practice Management (IGPM) notes with concern the findings published by the Nuffield Trust, in partnership with the King’s Fund and NatCen Social Research, highlighting the continued decline in public satisfaction with the NHS — now at the lowest level since the survey began in 1983.
We acknowledge the frustration felt by patients around long waits, difficulties accessing appointments, and pressures on staff. These are not just statistics — they reflect real experiences that affect trust and confidence in our health system, as well as the daily experiences of our members and the wider general practice workforce.
However, we must recognise the immense and growing pressure general practice is under, and how this affects the patient experience.
General practice is at capacity — and beyond
While public satisfaction with general practice remains higher than other parts of the NHS, it too has seen a decline — with growing demand, shrinking workforce numbers, and flatlining funding, despite rising complexity in patient need.
Practice teams are working harder than ever, but are often constrained by:
- A widening gap between patient demand and workforce supply
- Increased administrative and regulatory burden
- Rising complexity of care being managed within primary care settings
- Lack of investment in premises and infrastructure
- Difficulty in recruiting and retaining both clinical and non-clinical staff
Behind every practice is a team — and they are under strain
Management and administrative teams are the backbone of primary care — coordinating services, managing access, and absorbing the brunt of patient dissatisfaction when the system fails to deliver.
Our workforce is often:
- Subject to verbal abuse due to systemic delays outside their control
- Managing burnout, long hours, and emotional exhaustion
- Working without parity in pay, recognition, or support compared to clinical colleagues and other non-clinical staff in the wider NHS
What needs to happen
If we want to reverse declining satisfaction and restore faith in the NHS — particularly in general practice — we must:
- Invest in the whole primary care team, including non-clinical leaders and administrators
- Protect time for service improvement, not just survival
- Ensure that digital tools and triage systems are well communicated and appropriately resourced
- Support staff wellbeing and resilience, recognising that morale underpins quality of care
The IGPM also calls for:
- Greater representation of practice managers and management roles across general practice at all levels of system decision-making
- Recognition that general practice is a multidisciplinary service, not just a place to get a GP appointment
- Adequate funding, flexibility, and autonomy for practices to meet local needs
In summary
We hear the concerns of patients and of our staff — and we share them. Behind every statistic is a practice team working flat out in an underfunded, overstretched system.
The solution isn’t blame — it’s action. We stand ready to work with policymakers, commissioners, representative bodies and patient groups to make real improvements. But this must start with recognising the vital role general practice plays in the NHS — and the people who hold it together every day.
