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Editorials

General practice is making a leap in the dark

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5698 (Published 28 October 2016) Cite this as: BMJ 2016;355:i5698

Rapid Response:

Re: General practice is making a leap in the dark

Professors Marshall and Pereira Gray’s Editorial (1) was welcomed by a group of us in Derbyshire, South Yorkshire and Bassetlaw, where unfortunately, like GPs around the country, we are not seeing the resources promised in the ‘General Practice Forward View’ (2) reaching frontline services as yet. Cited by Professor Mathers as “one of the most important events for general practice since the GP Charter of 1966”(3), the NHS England led ‘vision’ style report pledges a 14% real terms increase in investment in primary care by 2020/21; this fits with the emerging ‘Sustainability and Transformation Plan’ (STP) model which aims to increase care for patients in their own homes with substantial increased investment in community services.

However, despite the GP Forward View bringing hope by acknowledging a chronically under resourced and increasingly demoralised GP workforce, we are disappointed to report that the only extra resource received in our regions so far is a woefully inadequate £800 - £2000 per practice for ‘resilience’.

On a positive note the STP have brought professionals from different arenas together for the first time; the local and regional enthusiasm, hard work and compassion for our patients and communities is heartening despite the current climate of austerity.

Sadly though many frontline GPs have not heard of the STP, let alone know what this acronym stands for literally or in practice as the NHS is yet again reorganised. This is perhaps due to lack of transparency of these documents thus far or heavy clinical workloads, which lead little time for reflection on NHS England reform.

We are fearful that the severe disconnect between the ‘vision’ of the ‘GP Forward View’ and ‘STP’ with the reality of funds not reaching General Practice could be catastrophic. The bed closures aimed for by the STP to ‘close funding gaps’ will lead to savings but at what cost ultimately to patient safety if funds to do not reach community services to replace them? GP and community services need the ‘Sustainability’ funds for training, infrastructure and staff before the service can be ‘Transformed’ to close any funding gaps.

References:
1 Marshall M and Pereira Gray D. General practice is making a leap in the dark. New models of working risk throwing the baby out with the bathwater. Editorial. BMJ. 2016; 355:15698

2 NHS England. General Practice Forward View. 2016. https://www.england.nhs.uk/wp-content/uploads/2016/04/gpfv.pdf [accessed 14.11.16]

3 Mathers N. General Practice Forward View: a new charter for general practice? Editorial. BJGP 2016; 66, 651. 500-501.

Authors:
Dr Liz Walton NIHR Clinical Lecturer, GP and RCGP Co-Ambassador for Derbyshire
e.walton@Sheffield.ac.uk

Dr Mark Torkington
GP and RCGP Co-Ambassador for Derbyshire

Dr Kathryn Markus, Chief Executive Derby and Derbyshire LMC
kath.markus@derbyshirelmc.nhs.uk

Dr Ben Jackson
GP, Clincal Teacher and RCGP Ambassador for Sheffield
ben.jackson@yh.hee.nhs.uk

Dr Ben Milton
ben.milton@northderbyshireccg.nhs.uk
Clinical Lead and Chair, NHS North Derbyshire CCG.

Competing interests: No competing interests

14 November 2016
Liz Walton
NIHR Clinical Lecturer, GP and RCGP Ambassador.
Dr Kathryn Markus, Dr Mark Torkington, Dr Ben Jackson and Dr Ben Milton.
Sheffield University
Academic Unit of Primary Care, Samuel Fox House, Sheffield University, Herries Road, Sheffield, S5 7AU.