The ‘confusing’, ‘incoherent’ Health and Social Care Act has only worsened the divide between primary and acute doctors, according to Royal College of General Practitioners (RCGP) chair Dr Clare Gerada.
Speaking at the RCGP Conference in Harrogate, Dr Gerada said that the act, and subsequent reorganisation, brought to a halt the integration that could have happened naturally.
She said: “Ironically, if the coalition hadn’t imposed this unwanted and unnecessary top-down reorganisation the move towards integration would probably have happened anyway.”
But Dr Gerada said that by working together as a team, doctors working across the NHS could vastly improve care.
Imagining the healthcare system in the future, she said: “Our relationship with our specialist colleagues must change. The way we work with them will change for the better, and the change will benefit us, them, and our patients. A ‘them and us’ divide symbolised by the hospital entrance will become a thing of the past.”
“The divide needs to become a thing of the past. In the future we will be working together in an integrated system of care – but first we must ask and answer some difficult questions about how we do things.”
According to Dr Gerada, who will step down from her role as chair in six weeks, the “twin scourges” of the NHS – poor continuity of care and fragmented care – were only made worse by the Health and Social Care Act.
She said: “Both made worse by multiple providers, competition, a market-driven healthcare service and the perpetuating the distance between commissioners and providers.”
Dr Gerada’s distaste for the Act which introduced the latest incarnation of clinical commissioning, aside, she believes that general practice must evolve.
“I believe GP practices working in isolation have served their purpose well, but their time has passed. Instead, we need all providers within a geographically aligned area to come together and pool resources. The RCGP federations could then launch into integrated care co-operatives. Provider organisations led by GPs.
“The aims would be to reduce fragmentation of care, improve continuity, deliver care as close to the home as possible and deliver best value for money.”
Dr Gerada took the opportunity of her last RCGP conference as chair to restate the pledges she was elected with three years ago – supporting young GPs, reducing healthcare inequalities and increasing GP training time.