Intended for healthcare professionals

Letters Challenge of multimorbidity

My hopes for a thriving primary care have been dashed

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m623 (Published 25 February 2020) Cite this as: BMJ 2020;368:m623
  1. Tom McAnea, GP principal
  1. Crookes Practice, Sheffield S10 1GN, UK
  1. tomcmc{at}doctors.org.uk

I found it heartening to read the consensus among leaders in our profession in Whitty and colleagues’ editorial on multimorbidity.1

As general practice continues to face a crisis of recruitment and retention, with ever increasing demand and medical complexity, and we struggle to maintain a safe and effective service, it would be logical to direct a major proportion of the “new” funding for the NHS at primary care. Generalists are essential to excellent patient care and the need for highly trained generalists is greater now than ever in the history of the NHS.

In my educational role I see bright and able new GP trainees coming through the system, but I fear that the reality of a career in this specialty given the current working conditions will lead to many leaving for overseas or seeking other careers. This is happening already.

For the NHS to offer true holistic care to our population, it must have a thriving primary care at its foundation. The NHS Long Term Plan and the direct enhanced service for primary care networks seemed to show some ambition in this direction and I felt some optimism, but this has been dashed with the latest publication of the specification for 2020-21. More work with fewer resources will bring the inevitable outcome. It can be done properly, we have the talent and the willingness, but it needs to be funded.

Footnotes

  • Competing interests: None declared.

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