The RCGP and the Patients Association released a joint report last week. Honestly, if you’re a GP reading this, I’d be surprised if you made it past the first page without nodding.
Focus groups, patient surveys, and GP polling all show the same issue: the NHS feels like a maze, and everyone is having trouble finding their way.
None of this will be news to you, but some of the data is still worth flagging:
A quarter of GP workload is spent on admin that doesn’t improve patient care or outcomes
Sixty-four per cent of NHS users in England faced at least one issue in the past year. These included lost test results, being unsure about next steps, and appointments they couldn't change.
17% of patients didn’t know if their referral had even been sent
26% ended up chasing it themselves
54% of GPs say their IT can’t properly communicate with secondary care
We all know that last one intimately. A result posted where you can’t see it, a letter that didn’t arrive, a patient before you asking what’s next while you’re just as lost. The RCGP Chair put it clearly: GPs waste hours navigating the maze with patients. They chase letters and follow up on referrals instead of focusing on clinical care.
The report highlights “patient agency” as key to all three recommendations. Patients should understand, navigate, and influence their care. They shouldn't have to rely on GP teams. This means you can track a referral, see their position on a waiting list, and get clear information about what happens next. Right now, for the majority of patients, that simply isn’t possible. And the report is clear that this isn’t just a technology fix. It requires genuine co-design, with patients involved in building the pathways, not just receiving them.
There’s also a digital inclusion problem that doesn’t get enough attention. Nearly 8 million people across the UK may lack the digital skills to engage with online services. These are often the patients with the most complex needs and the highest NHS contact. Patients who are digitally excluded frequently rely on NHS services the most. They can’t be an afterthought in any of this.
The workforce picture is where the report gets harder to read. There are now around 2,240 patients per fully qualified, full-time equivalent GP in England. That's a 16% increase since 2015. Also, 57% of RCGP members think they don't have enough time in appointments to build important relationships for holistic care. That erosion of continuity isn’t just frustrating for clinicians. It has a direct impact on outcomes.
The Nuffield Trust has been tracking a paradox: GPs who want to work cannot find jobs, while patients struggle to secure appointments. That’s not a numbers problem. That’s a funding and employment structures problem, and it’s been unravelling for years. Since 2022, GP job adverts in general practice across England have fallen by 45%. In London, the south east, and the north west, the drop is closer to 55 to 60%. The practices are there. The patients are there. But the funding to employ GPs isn’t keeping pace.
Part of the reason is structural. The Additional Roles Reimbursement Scheme (ARRS) started in 2019. It funded about 42,500 non-GP clinical staff into general practice. This included pharmacists, paramedics, physiotherapists, and physician associates. Since those roles got central funding, they often appealed more to practices than hiring extra GPs from core budgets. Patient satisfaction and the GP-to-patient ratio have changed together since 2015. When one declines, the other does too. The 2026/27 GP contract aims to solve this by repurposing about £300m of PCN funding for GP recruitment. Yet, it’s unclear whether this money is genuinely new or has already been allocated.
Meanwhile, 65% of GPs surveyed by Pulse in mid-2025 said they had considered working abroad. 70% reported work-related sleep disruption. 54% had reduced their sessions because of stress. These are not vague complaints. They are clear, specific, and reported accurately by those who know what they mean. The profession is not mildly frustrated. It is in genuine crisis, and the patients caught in the maze are the ones who feel it most directly.
The report’s three asks are straightforward.
1. Clearer information and properly co-designed care pathways. Enough GPs actually in post, with continuity built in rather than bolted on.
2. Digital systems should be interoperable and accessible. They must allow patients to track their referrals easily, without needing a degree in NHS administration.
3. Importantly, the authors flag that nearly 8 million people across the UK may lack the digital skills to engage online. Digitally excluded patients can’t be an afterthought in any of this.
What I think makes this report worth sharing is less about the findings and more about the format. Patients and GPs express similar views. They sit together in the same working group and co-create their requests. That kind of alignment doesn’t happen often enough, and when it does, it’s harder to ignore
