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The GPs who shaped NHS general practice: Professor Steve Field

To mark the 70th anniversary of the NHS, Emma Dent has been profiling some of the most influential GPs to have shaped NHS general practice over the decades. In this final instalment, she looks at the career of Professor Steve Field, most recently renowned for his role as the first chief inspector of general practice

stephen field

Professor Steve Field has long held prominent roles overseeing national policy in general practice, not always without controversy.

Chief inspector of general practice for the CQC since September 2013, Professor Field was already a contentious appointment for some, due to his long associations with Whitehall and leading a review into the Conservative/Liberal Democrat coalition’s health reforms.

He still practises as a GP one day a week at a large multi-practice Birmingham training practice so he can continue to understand the stresses and strains of general practice and enjoy seeing patients.

A former RCGP chair, he claims to be promoting the ‘amazing role’ of general practice ‘whenever I’m talking’. However, the profession might not agree with this assessment.

The CQC regime for inspecting GP practices has also often come under criticism for putting processes ahead of outcomes, and Professor Field has admitted that the recruitment process of primary care inspectors was slow to gain ground.

Professor Field often stresses that the vast majority of GP practices are good or outstanding – a claim held up by numerous CQC reports – and acknowledges that it is an underfunded sector. Acknowledging that those practices which have been found to be inadequate by the CQC were well known to be struggling, but their inadequacies have never been addressed by local or national bodies, he has also admitted that some practices may be inspected with more leniency than others.

But in 2015 he told a health select committee that as a GP he was ashamed by the poor quality of care provided by some practices.

This led to the BMA GP committee and the RCGP calling for his resignation, whom they said had ‘lost the confidence’ of those he claimed to champion.

General practice through the decades: The 2010s

Health secretary Andrew Lansley’s reforms see GPs apparently given control over their local health budgets through ‘clinical commissioning groups’, overseen by new body NHS England. The reforms also introduce the CQC inspection regime. GP numbers reduce, while the number of practice closures increase. NHS England's 2016 GP Forward View is unable to change this.

 

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