Calls for a revolution in general practice

Prof Chris Salisbury, head of the Centre for Academic Primary Care, was a member of the inquiry panel that recently published a report on patient-centred care, commissioned by the Royal College of General Practitioners (RCGP).

Called “An inquiry into patient-centred cared in the 21st century“, the report calls for a revolution in the way general practice is delivered, moving away from the traditional ‘cottage industry’ model of small, relatively isolated surgeries towards an era where clinicians work differently with patients, and practices increasingly work together at scale – for example in federations – with other parts of the health service.

“I was invited to be part of the inquiry panel because of my reputation on multimorbidity, which is built on work funded by the NIHR School for Primary Care Research,” said Prof Salisbury. “The report makes far-reaching recommendations to government, NHS England, CCGs, GPs and others.”

It recommends that the Government should set up a ‘transformation fund’ to drive a seismic shift in general practice – to deliver better care for patients, enabling people to take more responsibility for their own health and utilise modern technology to access services remotely.

It says this is needed to meet the diverging expectations of patients in the modern era, with many wishing to take advantage of rapid developments in IT to access clinicians and to take more responsibility for their own care, and a growing number needing increased support due to the explosion of those with multiple long term conditions.

According to the report, the Government and NHS England urgently need to increase funding for general practice and wider community based care, following a decade throughout which investment in hospitals has grown while funding for general practice has fallen substantially, with just 8.5% of the NHS budget now going into the family doctor service.

The report states that, practices working together at scale could become ‘multi-speciality community providers’ which, as well as having GPs, would include specialists, pharmacists, social workers, community nurses and workers from the voluntary sector.