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At the heart of general practice since 1960

What Jeremy Hunt’s GP rescue package really needs

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I understand that the final touches are being put on the much-delayed rescue package of measures to shore up general practice. Now called the ‘GP roadmap’ it could see the light of day as soon as next week, although I have yet to meet a GP who is dampening their undergarments about it.

Pulse has already reported that it has been delayed over the £110m funding promised to support it. The GPC asked at the time: ‘Have they got enough money to do what GPs and practices are now expecting of them?’ The answer? Probably not.

This would be a shot in the arm for a profession that is on life support

But they cannot afford to present the profession with another ‘new deal’ that fails to immediately address the three-headed beast of rising demand, bureaucracy and a depleting workforce that has been allowed to maraud in GP-land for far too long.

Morale is in the dustbin, a crap roadmap may just tip it in landfill never to be seen again.

But I would argue that there are three quick wins that could address some of the deep-seated problems in the profession, and perhaps more importantly give the profession a immediate morale boost (and as a mouthy journalist, of course I will tell you what they are).

First, crown indemnity for all GPs. This is the problem that I get the most comments and letters about and providing this for the whole profession would be a massive statement that our leaders ‘get it’. It would also provide a nice little income boost that is a bit too complicated to be understood by Daily Mail journalists.

Secondly, incentivise partnerships. The NHS has to tip the balance to tempt younger GPs into a partnership and give hard-pressed practices a helping hand recruiting. This will require a substantial cash pot, but the return on this investment to the health service cannot be underestimated.

Thirdly, and this is probably the most difficult. The head of the NHS must declare a moratorium on any new admin work imposed on GPs from CCGs, area teams or local authorities. Simon Stevens should say: ‘If you impose any more bureaucratic burdens on GPs then you will have to deal with me’ and set up a dedicated team in Skipton House to enforce this, with GPs invited to submit any examples of new paperwork they are having to complete. I even have a suggested email address: dontclogmypractice@nhs.net

And while we are at it, there should be an assumption that GP practices should be paid – particularly when CQRS has mucked up. Unless area team managers can prove otherwise. Oops, that makes four.

There are lots of other things that I could add to this – comprehensive mental health support, a campaign to improve public health literacy etc - and I am sure that you have your own ideas (comments please). But this would be a shot in the arm for a profession that is on life support, a real statement of intent.

Of course, what is badly needed over the longer term is a vision of how GPs are going to work in the next few years. An assurance that while things might get bad, the NHS is working to make it better. Not structures or organisations (MCPs, PACs, STPs or whatever) but a future where GPs can get back to the clinical care they were trained for, not what passes for general practice now.

If the ‘roadmap’ is going to live up to its name then it has to address the long-term goals too. But urgent solutions are needed now, otherwise you might as well return this package to its sender.

Nigel Praities is editor of Pulse

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Readers' comments (19)

  • Nigel- I view the limitless partnership liabilities as the final nail in the GP coffin. We must protect partners from the real possibility of losing their homes if it all goes belly up (as it has done in many parts of the country)

    You are more likely to retain partners if they are not running scared of being the last man standing.

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  • Peverley wrote frighteningly of the prospect of bankruptcy.
    CQC,Medical defence, litigation that can end your livelihood, GMC, bankruptcy, 50+ patients a day, 12- 13 hours everyday.
    Do NOT become a GP. that is the message.

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  • Allow LLPs to be in the NHS Pension scheme. My understanding is that partners in an LLP can not be in the NHS Pension scheme, thus preventing many practices from converting to LLP and limiting the huge risk that partners face.

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  • I agree with all the above.

    However, if this advice is too complicated for Hunt and co to understand, could he and NHS England and every other non-medically qualified busybody who know sod all about being a GP, just follow the advice of the Fat Man in 'House of God' and do
    'As much nothing as possible'
    ie just leave us the hell alone to do our jobs!

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  • Hunt's treatment of our profession has been deliberate, malicious, personal and without seemingly any understanding or empathy. This I imagine is the only kind of behaviour which he understands. Hunt wants us to remain in Europe for the good of the NHS so I'm voting out as a vote of no confidence in him or his ability to run the NHS. There are a lot of us in the NHS so that could amount to a lot of votes and perhaps a bit of a reality check for Mr Hunt. Might we also be able to get rid of that EU procurement law which CCGs use behind their COI rationale for not giving us any work?

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  • We have to have some brakes on consultations, like everywhere else in the world.

    All patients should pay a charge per consultation in general practice and accident and emergency. Obviously not the full price.

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  • Our locum insurance to cover partners illnesses is increasing, now several thousand pounds per annum, and deferred periods vary usually 4 to 12 weeks. GPs have thus often worked through illness but at a cost to their own health. Does anyone care about us? It feels not. Support for sickness absence at times of need would be welcomed, not only by the unwell individual,but also by his/her colleagues who carry the burden of additional workload at such times.There is no slack in the system, we are working at capacity, and struggle with workload, insurance costs, and inconsistent locum availability.

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  • I am 57. I am the generation who worked 1 in 2 rotas when we were paid a third of basic pay for unsociable hours. I was thrown out of my first GP practice when I became pregnant.
    More recently I took 4 weeks off work for cancer treatment, during this time I had calls from my partners urging to come back to work. When my husband had major surgery for cancer I was able to take a few days off but it was part of my annual leave allowance. I am in work by 7am and rarely leave before 7pm. During my time in work I do not have a break and struggle to find time to go to the bathroom. I am dealing with increasingly complex medical, social and psychological problems.
    I can't wait to retire. It's going to take a lot to improve my morale, sadly I don't think Mr Hunt cares.

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  • If it's coming from Hunt it'll be poisonous crap
    I wasn't aware Hunt was in favour of remaining in the EU (above comment) - I was undecided but anything Hunt is in favour of is reason enough for voting against.

    Crown indemnity for GPs would be great. But I suspect If we get it it'll be tied up with strings so tight it might not be worth having

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  • To 10.46pm, just take early retirement. It is not worth it. Life is too short. Look after yourself and your family first. The NHS will not thank you. Stress is not good for cancer or for recovery after cancer treatment. Early retirement is not the right description as you have gone though an endurance course for all those years and now is the time to cash in your chips at the practice and leave. You could always locum but at least you will have more control.
    For goodness sake cancer is all about getting rid of waste and detoxing, but if you struggle to get time to go to the loo, is that going to be good for you? May have partly caused your cancer in the first place!

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