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Crystal-ball gazing for 2009

There can be few more foolhardy ways of starting a brand-new blog than by offering up a list of crystal-ball gazing predictions, knowing how easily they will be proved or disproved over the coming months.

By Steve Nowottny

There can be few more foolhardy ways of starting a brand-new blog than by offering up a list of crystal-ball gazing predictions, knowing how easily they will be proved or disproved over the coming months.

But at this time of year, as the nation stumbles back to work and draws its collective breath for a tough 2009, it's very much in fashion. So here goes nothing. Here's five trends that GPs should be looking out for over the next twelve months.

  • Full steam ahead for tighter regulation. The Care Quality Commission won itself few friends at the end of last year when it promised to use its ‘draconian' powers to ensure GPs follow NICE guidelines. But the commission is taking criticism in its stride as it establishes itself and prepares to usher in a new era of regulation. And perhaps even more significantly, plans for revalidation are forging ahead. The RCGP launched a rapid consultation on the proposals at the end of last year, and with the GPC largely on board as well, it looks certain to become a reality sooner rather than later.
  • But polyclinics pause for breath. They were undoubtedly the buzzword of 2008, and a massively significant development, the full consequences of which have yet to be felt as the new wave of GP-led health centres start competing for patients across the country. But the lightning procurement last year has taken its toll on PCTs, who are still struggling to turn Lord Darzi's dream into a reality. Expect 2009 to be a period of adjustment, with all talk of a further rollout postponed until we see how the first batch works out.
  • Private sector to keep circling. Whether or not the private sector makes any further inroads into primary care this year depends largely on the wider economic climate, and there's no doubt that the global financial crisis has scared off some would-be suitors. But make no mistake – private sector investment in healthcare is on hold, not cancelled. GPC leaders will be watching this space very closely indeed.
  • Financial confusion. No, nothing to do with the general doom and gloom – this relates very specifically to general practice. Somewhat unexpectedly at the end of last year, the GPC and Government agreed a number of key contractual points, notably the beginnings of the MPIG phase-out and the scrapping of the square-root formula. BMA and Department of Health economists have been hard at work modelling the likely effect of these changes, but now more than ever, practices should expect the unexpected. Watch for at least one of the changes to throw up some unlikely winners and losers.
  • Make or break for the Summary Care Record. With an election likely in 2010, and the future of a centralised care records system extremely uncertain under the Tories, it really is now or never. Connecting for Health believe that, after changes to the consent model, they have finally got it right. But so far the Summary Care Record has been piloted in just a few highly controlled early adopter areas. When the national rollout begins in April – and GPs and patients across England are forced to grapple with all its wider implications – the true test will begin.

Even if all five come true though, the chances are it will be something else entirely dominating the headlines come this time next year. So feel free to add your own Mystic Meg efforts below. What else should GPs be expecting in 2009?

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