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Wider primary care teams are secret to future general practice

MPs call for primary care share of NHS funding to rise

Adrian O'Dowd

Thursday, 21 April 2016

Primary care in the future should be provided by a wider range of professionals to allow GPs more time for patient appointments, according to MPs in a report published today.

MPs on the influential parliamentary health committee also called for primary care to have a greater share of NHS funding.

The report, based on the committee’s recent primary care inquiry, says primary care is the bedrock of the NHS and the setting for 90% of all NHS patient contacts but was under “unprecedented” strain and struggling to keep pace with rising demand.

The traditional model of 10-minute appointments with GPs no longer allowed them to provide the best possible care for patients living with increasingly complex long-term conditions.

“The priority for government should be to train, develop and retain not only more GPs but wider multi-disciplinary teams working within a more integrated system of care,” it says.

Multi-disciplinary teams could use the skills of GPs, physiotherapists, practice nurses, pharmacists, mental health workers and physician associates.

Committee chair Dr Sarah Wollaston said: “If we are going to provide the best possible care for people living with increasingly complex long-term conditions, then primary care has to be able to change. We need to allow for longer appointments and for people to be cared for by a wider range of professionals.

“It is also vital that people have access to timely appointments yet that remains a serious issue for many. The priority for the government should be the workforce and to make sure that we train, develop and retain the multidisciplinary teams as well as the facilities and technology they will need to provide the best care for patients.”

Despite rising demand for services, primary care’s funding had fallen behind as a share of the overall NHS budget, said the committee, which recommended that it should receive a larger proportion of overall NHS spending in order to improve access and services for patients.

On the issue of the government’s aim to create a system in which routine GP care is available seven days per week, the committee was sceptical.

Dr Wollaston said: “The government made a manifesto commitment to seven-day access to services but needs to clarify how this commitment is to be implemented and resourced, especially in light of the workforce shortfall.

“We welcomed the goal of improving access for those who find it very difficult to attend midweek appointments, but recommended that practical application of the seven-day policy should be locally designed and led by the evidence.

“It should take account of local recruitment challenges and the potential impact on continuity of patient care as well as the capacity of weekday services and any unintended consequences for urgent out-of-hours primary care cover.”

MPs also acknowledged the current problems faced with recruitment and retention of primary care staff and the particular challenge in attracting young doctors into general practice.

Dr Wollaston added: “Patients need more health professionals from a range of disciplines to choose careers in primary care. Existing medical education does not encourage graduates to do so and greater attention must be paid to the needs of patients in designing training pathways and incentives across the entire NHS workforce.”

How would qualify the communication between primary and secondary care services? (See OnMedica News 20/04)

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