Primary care in England needs further innovation

A new report has argued that new models of general practice could be imperative in realising the potential of wider NHS changes in England.

The Innovative models of general practice report, published by The King’s Fund, looked at seven researchers, including three GPs or GP trainees, and identified five characteristics that define general practice in England: person centred holistic care; accessibility; coordination; continuity; and community focus. The report authors argue that, although ‘some may be more important for some patients and at particular times’, all five ‘must be present for general practice to deliver effective and comprehensive care’.

Promoting person-centred, holistic care is ‘the core tenet of general practice’, as it increases patient satisfaction and ‘supports people to take control of their own health’. Also important, the paper reports that most patients only want to tell their story once, so there is an increasing need to co-ordinate care properly between clinical staff within practices, and between practices and the wider health system.

Alongside workforce and funding solutions, the King’s Fund claims that general practice needs new clinical delivery models to meet the demands of a changing population, disease burdens, and public expectations. Part if this involves a shift from reactive to proactive care, often involving using electronic records, as this will provide ‘ongoing support for comprehensive care’.

The report also says that technology innovations should ‘underpin ways of working, rather than replace them’, maintaining the importance of digital access complementing rather than replacing teamwork and information sharing.

Helen Stokes-Lampard, chair of the Royal College of GPs, said: "Workload in general practice has increased exponentially over recent years, both in terms of volume and complexity, yet the share of the NHS budget we receive is less than it was a decade ago, and GP numbers are decreasing.

"GPs and our teams have always been at the forefront of innovation in the NHS. Across the country we are already working differently to retain the key features of our general practice, as highlighted in this report, including continuity of care, a person-centred approach to care and easily accessible care, close to home in the community.

"We know that these are also the things our patients value about general practice, and why GPs are consistently rated amongst the most trusted healthcare professionals in the NHS. GPs are certainly not scared of change, but we do need the support and resources to implement change effectively, in the best interests of patient care, and ultimately the wider NHS. This report underlines just how important it is that NHS England's GP Forward View, including £2 billion extra a year for general practice and 5,000 more GPs by 2020, is delivered in full and as a matter of urgency.”

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