Posted by: Editor's Blog8 November 2013
The GPC’s blueprint for the future of general practice, published yesterday, is a curious sort of document. Curious in its scope, curious in its ambition - and most of all curious in its timing.
At just 15 pages in total, it’s worth reading in full – and if you do, you’ll immediately see it’s very much a hybrid paper.
It begins by making the case for general practice as a whole, highlighting the 300 million patient consultations a year, the unsustainable rise in GP workload, the fall in the proportion of funding going to general practice. Then it moves on to ‘providing solutions’, with a series of recommendations that veer between the motherhood and apple pie (‘more integrated care’) to the substantial (‘set a minimum clinical staff/population ratio for OOH organisations’) to the somewhat startling (networks of practices providing ‘extended hours surgeries at a range of different times across a community’).
Taken as a whole the document has had, it’s fair to say, a mixed reaction. ‘Not so much a “blueprint”, more of a slightly blurred greyprint,’ was how Dr Richard Cook put it on Twitter. ‘The report in the round an excellent roadmap for the future of general practice’ was Dr Grant Ingrams’ more upbeat assessment. The comments on Pulse’s website were largely critical, with several in the ‘membership cancelled’ vein. Such vitriol is unlikely to reflect the views of the profession as a whole – but nor were there many GPs queuing up to offer words of praise.
Which brings me to the most curious point of all about the GPC’s roadmap – its timing. A very significant round of GP contract negotiations is expected to conclude ‘within weeks’, we are told. A vision document put out by the GPC at exactly the same time as negotiators are locked in last-minute talks with NHS England is inevitably going to be overshadowed by the fact that real, concrete and potentially very significant contract changes are right around the corner.
Are there clues in the GPC’s roadmap to what those contract changes might be? Possibly. Approving talk of ‘named clinicians’ suggests that Jeremy Hunt’s plans for named GPs are, as we have already reported, likely to get the GPC’s approval. Other aspirations though are surely unlikely to be fulfilled - five-year training feels like a reach given four-year training is yet to receive Treasury approval, while the demands for premises funding seem somewhat optimistic.
If anything, the GPC’s paper, coming at the time it does, should best be seen as a skeleton argument, a glimpse into how negotiators may have made the case for general practice as they entered what are sure to have been a difficult round of contract talks.
How the Government’s aspirations for general practice will be implemented in the contract is likely to be much more significant. We should know more shortly.