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GPs to consult via social media and take on more roles

But more investment needed to achieve RCGP’s vision for the future

Louise Prime

Friday, 21 June 2013

GPs will soon be consulting with patients via social media, working with others to deliver more responsive out-of-hours care, and taking on extended clinical, professional and training roles, according to the Royal College of General Practitioners’ vision statement published yesterday. But College chair Dr Clare Gerada (pictured) warned that in order to achieve these ambitions, far greater investment and a larger, more skilled workforce will be needed.

In The 2022 GP, the College predicts that within a decade patients will expect remote access to their GP or nurse, to be able to attend virtual clinics with GPs and specialists, and to communicate with their doctors using text messaging or social media.

It said: “In 2012, around 95% of 16–20 year-olds and 74% of 20–25 year-olds used Facebook each month. To this generation, the traditional face-to-face consultation will no longer be accepted as the ‘default’ way to access care.”

The RCGP also called for a radical shake-up of out-of-hours care, to improve responsiveness, as well continuity and coordination of care between the practice team and others on a 24/7 basis. But it stressed: “This does not mean a requirement for GPs to provide direct patient-to-doctor access out of hours: it is about the need to reshape services ...

“Working together across federations of practices will facilitate better out-of-hours responsiveness and the ability to develop different models that are able to address the needs of different populations of patients.”

The College’s vision includes evolution of the GP’s current role, which it describes as that of “omnicompetent independent doctors”, towards being “part of a family of interconnected professionals who share a common core philosophy and set of skills acquired from enhanced generalist training”.

It says individual doctors would build on their generalist expertise by taking specific training for additional roles. These would include extended clinical roles (such as leading the care of patients in nursing homes, or those with dementia or substance misuse problems); extended roles in population health (such as tackling inequalities, building community resilience, quality improvement, commissioning and service redesign); and extended roles in education, training, leadership and academia.

But the College warns that only a major shift of funding into general practice to address the current imbalance – including increasing the number of GPs by at least 10,000 across the UK, and investment in practice premises – will enable its vision to be fulfilled.

Dr Gerada pointed out that, currently, GPs provide 90% of NHS care for only 9% of the NHS budget. She said: “None of this vision will become reality if we do not receive fairer investment for general practice.

“The Government must recognise that general practice is the most cost effective way of providing care and act accordingly, by urgently reversing the real terms decline in the amount of money that general practice receives.”

Her remarks echo comments made by Berkshire GP and Conservative MP Dr Phillip Lee, in a report published jointly yesterday by the Nuffield Trust and The King’s Fund. He said: “We need to restructure our acute health care services, which will require district general hospital closures, consolidation of acute specialist services into larger, new ‘hub’ hospitals ... to release funds which can help to improve the quality and performance of community care.”

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