GPs' share of NHS spending has fallen to a ten-year low, Royal College of GPs says

The share of NHS money spent on general practice has fallen to its lowest level in a decade, the Royal College of GPs said on Monday, in a report that argues plans to move care out of hospitals will not work without more funding for family doctors.

The college's State of General Practice report covers all four UK nations. It was published two days before the Budget and ahead of the college's annual conference, which opens in Glasgow on Thursday.

Where the money goes

In England, general practice received 8.3% of NHS commissioning spending in 2024 to 2025. Analysis by the Health Foundation, published in August, shows the share was 8.8% in 2015 to 2016 and briefly rose to 9.2% before the pandemic, before falling back. Over the same period, the share spent on acute services, mostly hospitals, increased from 38.4% to 42.6%.

Spending on general practice has still grown in real terms. But the Health Foundation found that much of that growth came through primary care networks and other funding streams rather than direct payments to surgeries, and that practices received less per patient in 2024 to 2025 than a decade earlier. The 2026 to 2027 GP contract commits £219 per patient for a full year of care, which the think tank noted is well below the average cost of a single ambulance call-out or A&E visit.

What the college wants

All four UK governments say they want more care to be delivered in local communities, more use of technology and a greater focus on preventing illness. The college says general practice is central to all three, but that investment has not kept pace with what is being asked of it.

Its main proposal is a primary care investment standard, a commitment that would give general practice a rising share of the NHS budget over time. It is also asking for action on workload, better digital systems and money for surgery buildings.

A survey of more than 1,500 of its members found that only 36% felt they had enough time in appointments to build relationships with patients. Seven in 10 said they did not have time to give advice on preventing illness, and more than one in five said they felt so stressed on most days that they could not cope.

The government's position

The Department of Health and Social Care said GPs were central to its 10 Year Health Plan and to the shift towards care in the community. It said £1.7bn had been invested in general practice over two years, £100m spent on refurbishing surgeries, and more than 2,800 extra GPs recruited, giving the highest number of fully qualified GPs since 2015. It added that record numbers of appointments were being delivered and that 77% of patients said they had a good local GP service.

What happens next

Health spending plans for England were set at the spending review, and Wednesday's Budget will show whether the government changes the overall envelope. How much of that reaches general practice, and in what form, is settled separately through the annual GP contract.