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Hospital leadership won’t solve GP workforce crisis, practice managers say

by Jess Hacker
2 February 2022

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Alleged plans to bring general practices under the control of hospital trusts would not improve workforce morale or patient care, practice managers have said.

Such a shift would see further harm brought against the primary care workforce’s ‘already low morale’, the Institute of General Practice Management (IGPM) told Management in Practice.

Its directors added they are ‘not convinced’ that GPs being managed by remote hospital teams would show improvement in patients’ overall health.

It comes in response to a report from The Times this weekend, which claimed that the health secretary Sajid Javid is set to conduct a full review of general practice.

This review could see GP practices fall under hospital management, with practices incentivised to join trusts, the report said.

Mr Javid is reported to have said the current contractor system used for general practice has ‘considerable drawbacks’, namely the ‘underinvestment in prevention’.

However, the IGPM stated that ‘if primary care was adequately funded, more work could be done around prevention alongside the wider healthcare system’.

The directors said: ‘We believe that general practice is already run very efficiently with minimal wastage. The independent contractor model means that partners are much more invested in making practices work without wasting public money.

‘There is a community investment in the GP surgery model as a result of this independent ownership with staff and clinicians knowing what their locality needs are and how best to serve them.’

They also said that the proposed management style could risk forcing GP teams to ‘supply shortfalls in secondary care staffing’, potentially worsening the general practice staff ‘exodus’.

Practices under trust leadership

According to The Times report, the proposed restructure would not constitute a ‘forcible state takeover’ but did state it would see practices ‘nationalised’: a claim the DHSC has denied.

In a letter sent to the prime minister, and seen by The Times, the health secretary said that his independent primary care review will consider ‘how GPs work with the other parts of the NHS such as hospitals’.

The Times reported that this will be done with the intention of introducing closer working between primary and secondary care.

The plans aim to reduce hospital admissions by making GPs ‘do more to keep patients out of hospital’, according to the newspaper’s report.

However, a DHSC spokesperson told Management in Practice’s sister title Pulse that it has ‘no plans to nationalise general practice’.

They said: ‘We are incredibly grateful for the phenomenal work that GPs do for their patients and have invested £520 million to improve access and expand GP capacity during the pandemic.

‘Now we have moved back to Plan A we will continue with our plans to tackle waiting lists and deliver the ambitious reforms needed to help our health and social care system recover.’

The model is similar to a system currently in use in Wolverhampton, where 10 local GP practices are run by the Royal Wolverhampton NHS Trust.

Elsewhere, the plan has been subject to heavy criticism among stakeholders.

The NHS Confederation said the proposal was built on a ‘false premise’ that hospitals are busy due ‘failures in general practice’, which would be read by hardworking staff as ‘deeply offensive’.