GPs need “coherent” picture of future care models, says NHS Alliance

GPs still need to get a “coherent” picture of how they will work in the future under the government’s proposed new models of care, the NHS Alliance has said.

Its chairman, Michael Dixon, said that there was still no clear plan for primary care in the implementation of NHS England’s Five Year Forward View. He said that ideas for new vanguard organisations (www.england.nhs.uk/ourwork/futurenhs/new-care-models) were “exciting” but that there was “no connected thought” between politicians, the Department of Health, NHS England, clinical commissioning groups, and the mass of GPs “on the ground.”

Dixon was speaking at a seminar on the future of the NHS hosted in London on 20 October by the Westminster Health Forum. He warned that there should be no rush to bring in a model of the “corporatised GP” and said that the basic strengths of general practice must be preserved. “It could be a new dawn if we get this right, but it could be a catastrophe,” he said.

Dixon said that the “crucial formula” that had made family medicine so strong and cost effective was the personal care and continuity of care that a GP could offer to patients and the local population.

The NHS vanguard sites had the potential “to impact on the whole of local health,” not just the patients on a GP’s list, but they involved a small minority of GPs, he said. “What about the other 90% of the country,” he said. “That’s going to require a hell of a lot of extra work and time and effort to make things change.”

The conference heard how more GPs could find themselves working in larger practices while keeping the same concept of the registered list. Or they might be employed as part of integrated care organisations, or by hospitals, limited companies, or primary care organisations, he said.

Dixon added, “I don’t think we yet know what a corporatised GP is like and whether that is what patients want and whether it is what clinicians will sign up to.

“I think we need to run these models in parallel for a while just to see exactly what happens.”

He said, “My fear is that as we go to the new models we forget relationships. And relationships are not only what people want: they have a very hard economic bite.

“What we don’t have yet in primary care is a coherent implementation policy. We need a policy that joins patients, clinicians, and organisations, to give a picture of what primary care in the future can be.”