BMA sees hope for rebuild of general practice
Author: Louise Prime
Increasing numbers of GPs believe that general practice is finally turning a corner and there is light ahead for the profession, according to the British Medical Association (BMA). It welcomed recent wins for GPs on both indemnity and contract changes in England, but insisted that no practice should feel pressured or bullied into joining an integrated care partnership.
BMA GP Committee chair Dr Richard Vautrey told delegates yesterday at the conference of local medical committees in Belfast that he has seen hope among GPs that “we can rebuild general practice”. But he said the additional £20bn for the NHS, and “an NHS first of preferentially investing in primary medical services” – although long overdue and welcome – is “nowhere near enough to repair the damage done by a decade of austerity”. He called for greater investment in people and in information technology in practices; for local services to be built up and supported; for increasing emphasis on self-care and less on getting doctors’ notes; and he warned that “the spectre of the integrated care provider contract” could disempower and destabilise practices.
Dr Vautrey argued that it “beggars belief” that clinical commissioning groups and NHS England have allowed GP at Hand to expand even before their own commissioned report has been published. He noted: “As GPs we want to build services in the communities we work in and serve. We don’t want them undermined by ‘here today and who knows where tomorrow’ digital services,” and he warned that greater investment in IT for practices is essential, with the deployment of broadband and IT infrastructure upgrades as soon as possible.
He urged the government to join GPs in managing demand and tackling overmedicalisation, empowering more people to self-care rather than promising that patients can be seen more quickly by already overstretched GPs. He said: “If they really wanted to free up appointments they could stop anyone and everyone [from] telling people to ‘just get a note from your doctor’. And to make a real difference to our workload, governments could set an example by trusting people more and scrap the current antiquated, costly and completely unnecessary system of fit notes. It really is time employers and government stopped passing the buck to GPs and that we all empowered our patients and stopped treating them like children.”
He noted that for many GPs across the UK, the problems created by practice premises are “still a huge issue, and putting many doctors off becoming GPs in the first place”, which threatens the necessary aim of an expanding multidisciplinary workforce. He welcomed the agreed premises loan scheme in Scotland, and called on the other UK governments to “step up their support for practice premises”.
He went on: “In England we have other potential challenges and can still see the spectre of the integrated care provider (ICP) contract, a contract that rather than empowering practices could disempower them, and that rather than providing stability risks instability with the threat of wholesale private take-over. Let’s be clear, no practice should feel pressured or bullied into joining an ICP. With the development of primary care networks, built on the GMS contract, there is no justification for undermining this and the concept of ICPs should be confined to the history books even before they get off the drawing board.”
Dr Vautrey called for investment not just in practice baselines but also in people – with support from other colleagues such as pharmacists, district nurses, health visitors, palliative care nurses, social workers, drug and alcohol therapists, occupational therapists to “shoulder the workload burden and help GPs focus on what we alone need to do”.
He concluded: “Travelling the country following our contract agreement in England I’ve had a real sense that growing numbers of GPs believe that we are finally turning a corner. There is light ahead of us. The 12 years of austerity we have had to cope with may be behind us, but the damage was severe and it will take many years to recover. But at last there is a sense of hope, a hope that we can rebuild general practice, that we can develop community-based services and that we can once more make being a GP an attractive profession to both join and stay in.”