General practice is truly at a crossroads. It is facing many pressures and challenges, but also opportunities. The expectations of healthcare are changing from all points of view: patients; policymakers; the NHS; GPs; and practice teams themselves.
Some quarters are expressing uncertainty about the future of general practice, and there are those who believe the profession does not have solutions for the problems that the health system is facing. The RCGP knows they are wrong.
UK general practice is the envy of the world when it comes to quality and standards. Other countries are trying to replicate what we are thinking of dismantling. The reality is that GP teams are making a marked difference to patients’ lives – on every working day, 800,000 people will visit their practice and 1.5 million prescriptions will be issued. More than 90% of the work of the NHS is done in general practice, and we are dealing with increasingly complex and complicated clinical problems.
But the status quo is not sustainable, and choices have to be made about the direction of health policy. If we are to meet the health needs of patients over the coming years, we will need to bring about a radical change in the quality, organisation and delivery of services.
The RCGP landmark document The Future Direction of General Practice: A Roadmap provides the vision for better patient care in the NHS.1 It maps the way forward, and demonstrates how the enormous potential of primary care can be maximised to bring about major improvements.
While published prior to the announcement of Lord Darzi’s review of the NHS, it provides a solution to problems such as access to GP appointments, fragmentation of care, health inequalities and urgent care.
We believe it is possible to deliver change for the better using a variety of models that build on the strengths and values of general practice. Using a “federated” approach with primary healthcare teams and practices working together, virtually all health problems – including mental health – could be dealt with in primary care.
Patients want local personal care rather than being treated as a number; they want to see a doctor they know and who knows them. We hope that this document will be used to challenge policymakers and to support business cases for developing local NHS services that build on these values.
The roadmap is supported by all the major general practice organisations, and represents an unrivalled opportunity for GP practices to put forward their own ideas for improving patient care and establish themselves as a force to be reckoned within their local health economies.
It is an ambitious declaration for the future of general practice and the wider NHS, and politicians and policymakers must do everything they can to support GPs and practice team colleagues in its implementation. General practice is not the cause of the problems in the health service – it is the solution.
On a final note, this will be my last column, as I step down as RCGP Chairman this month after three years. I am extremely proud of what we have achieved in general practice during this time – and thank you for the personal help, advice and support so many of you have given me. It has been a privilege to lead the College through such an exciting chapter in its history, and I am confident that, with your endeavour, great times lie ahead for general practice.
The future is rosy for general practice, and I want practice managers to play a full part in this by embracing the cause of higher quality and better patient experience. Practice managers must step up to the plate and take up this challenge.
1. Lakhani M, Baker M, Field S. The future direction of general practice: a roadmap. London: RCGP; 2007.
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