The State of General Practice in England

In 2024, the pressures of running an effective GP practice are higher than ever before.

While demand for help from GPs has been steadily increasing year-on-year since the 2010s, the last few years have been the most difficult by far – for practices, their staff, and of course, for patients.

As many of our patients will have experienced, since the pandemic, waiting lists for operations, to see specialists in hospitals, and to be seen in A&E have reached extraordinary levels. And while patients are being forced to wait, they are increasingly having to turn to their GP practice to look after them in the meantime.

National statistics show that GPs are now offering and delivering 30% more appointments than they were in 2019, despite general practice in England receiving a real term cut in investment versus previous years. Facing these significant struggles, hundreds of GP practices across the country have been forced to close, with small, village-surgeries hit particularly hard by increasing performance demands and costs looming larger than their funding. Those surgeries who remain work incredibly hard to live up to their patients’ expectations but are increasingly shackled by financial limitations.


The Middlewood Partnership: General Practice Redefined

The Middlewood Partnership is not impervious to these pressures, but with foresight, have positioned ourselves to continue to deliver excellent patient care to our population. We knew that we would have to work differently to continue to serve the people of Bollington, Disley and Poynton, and in 2019, merged our four practices to become a more robust and effective organisation.

Joining forces and working together has allowed us to amalgamate many of our functions, including our urgent care, back-office administration, on-call and triage services, performing at scale to deliver services that would not have been possible as individual practices.

We are proud of our efforts to build and maintain continuity of care for our population, allowing our patients to see a single, named GP for their appointments where appropriate. Throughout the 2023-24 financial year, on average, Middlewood’s patients saw their usual doctor 71.2% of the time for their ongoing health concerns – almost doubling the national average. This commitment to continuity has helped to reduce the need for patients to retell their histories at each appointment, garner trust between our doctors and our patients, and increase the effectiveness of our interventions.

At the same time, we have taken care not to unduly delay patients to maintain that continuity, doing our best to offer efficient access to services for our patients. On average in 2023-24, our patients are booked in within two weeks of contacting us 82.1% of the time where appropriate, and we’re working hard to reach the target of 85% going forwards.

Whether it’s urgent care, continuity, access to appointments with our multidisciplinary team, or the quality of our service, we have managed to maintain and build on the work of our four individual practices by forging our Partnership, and continue to outperform the majority of practices in the country.

But all told, The Middlewood Partnership is feeling the same pressures as those facing all general practices in England. We hear your frustrations and thank you for your feedback. Our staff work hard every day to continue to improve our services, and to maintain safety and accessibility – aiming to give you the very best service we can provide under the constraints we are facing.

We invite you to learn more about the struggles facing general practice today by visiting: