Re: Partha Kar: Applying aviation safety to healthcare—are we missing the fundamental?
Dr Kar makes a very strong point about the mismatch between capacity and demand. Whether we look at the NHS ten year plan or the new GP contract deal, there is talk about more staff but these major initiatives lack any solid workforce planning.
In general practice, we have seen average rate of consultation more than double in the last decade and clinical as well as well as managerial demands have soared. This has not been helped by dwindling numbers of GPs in proportion to the population.
Increasing workload has affected the recruitment and, at the same time, has also seen other roles develop e.g. paramedics carrying out routine or urgent house visits, a variety of nurse practitioner roles, etc. These are in some ways, desperate measures in attempts to cope with the workload as the skill sets can be different and some of the work delegated can be highly complex, challenging for the training provided. It also has had a disastrous effect on continuity of care and establishment of relationships with families. If we do not see them for minor conditions and are not able to establish the trust and rapport of a traditional family physician, our ability to absorb uncertainty, take risk and make sound judgments when they are not well, also goes down. Will we still be as resource-effective in future, is in doubt.
Competing interests:
Vice chair South Durham health, a GP federation which employs a variety of primary care team members.
Rapid Response:
Re: Partha Kar: Applying aviation safety to healthcare—are we missing the fundamental?
Dr Kar makes a very strong point about the mismatch between capacity and demand. Whether we look at the NHS ten year plan or the new GP contract deal, there is talk about more staff but these major initiatives lack any solid workforce planning.
In general practice, we have seen average rate of consultation more than double in the last decade and clinical as well as well as managerial demands have soared. This has not been helped by dwindling numbers of GPs in proportion to the population.
Increasing workload has affected the recruitment and, at the same time, has also seen other roles develop e.g. paramedics carrying out routine or urgent house visits, a variety of nurse practitioner roles, etc. These are in some ways, desperate measures in attempts to cope with the workload as the skill sets can be different and some of the work delegated can be highly complex, challenging for the training provided. It also has had a disastrous effect on continuity of care and establishment of relationships with families. If we do not see them for minor conditions and are not able to establish the trust and rapport of a traditional family physician, our ability to absorb uncertainty, take risk and make sound judgments when they are not well, also goes down. Will we still be as resource-effective in future, is in doubt.
Competing interests: Vice chair South Durham health, a GP federation which employs a variety of primary care team members.