The role of the “medical generalist” in the guise of a GP must be protected and enhanced for the future as the NHS reforms take place, concludes a new report published by the RCGP.
The report Medical generalism: Why expertise in whole person medicine matters says the GP’s role is vital and should be more widely recognised and boosted to allow the NHS to meet the challenges it is facing under the reforms.
This report is the RCGP’s formal response to the findings of the Independent Commission on Generalism, published last year. The Commission was established by the RCGP in partnership with the Health Foundation to examine the contribution and role of GPs and generalists in the healthcare system.
It outlines the college’s overall position on the future of medical generalism, explores the challenges raised in the Commission’s report and proposes a programme of work to address issues such as continuity and access.
In the new report, the college argues why “experts in whole person medicine” matter to all healthcare systems and why the importance and influence of the role needs to be given fresh consideration within a much wider context than general practice and primary care.
GPs should be given more support to protect and enhance their role, including longer training; more time with patients; better access to diagnostics and better communication with specialists, it argues.
The RCGP has identified 10 priority areas that aim to review the disciplines of GPs and other medical generalists from different perspectives and ensure they are equipped to meet the changing needs of their patients.
These areas are:
- effective use of patient feedback
- policy on out-of-hours care
- development of generalist models of care for complex and chronic conditions in the community
- improved communication between GPs and specialists
- extended training for GPs
- enhanced training in paediatric care, learning disabilities, mental health, palliative and end of life care
- GP-led commissioning
- further research into multiple morbidities and early, accurate diagnosis in primary care
- use of IT, data sharing and inter-agency e-communications
- nursing home care.
To prepare the report the college consulted widely with its members and other stakeholders using various methods including debates and regional listening exercises.
RCGP honorary secretary Professor Amanda Howe who is leading the work, said: “Generalists are professionals who are committed to the patient as a person. They retain responsibility for patients over time, deal with many issues and help patients to make judgements that are safe for them and the system.
“The GP remains the front door and the community interface of the NHS and principles of practice are still based on two key concepts: holistic and patient-centred care. Our report shows that GPs are very positive about seeing the basis of our discipline from a new perspective and are keen to have the value and skills of medical generalists more strongly supported across the modern NHS.”