This crisis offers the chance for a radical change of mindset
In our first issue after Covid-19 truly hit the UK, we labelled it ‘the virus that will change general practice forever’. Three months on, this view has not altered.
This change could be great. I’m not talking about remote consultations, effective triage or better infection control. I’m talking about a change in mindset that will liberate GPs to do what is best for their patients. The response to the pandemic has provided a blueprint for the future.
First, the death knell should sound for pointless bureaucracy. It was acknowledged early on by health managers that practices would need to be freed from bureaucratic shackles. CQC inspections were wound down, appraisals and revalidation were put on hold, the QOF and enhanced services were suspended. This allowed practices to reconfigure services. In other words, they were able to improve patient safety and care because they weren’t having to prepare to be assessed on patient safety and care.
NHS England has said bureaucracy that was a ‘poor use of time’ should not be reinstated. Let’s hope its definition of ‘poor’ is similar to GPs’.
The GP initiatives I have heard have been awe inspiring
Second, as our cover feature this month shows, the pandemic has demonstrated just how flexible the partnership model is and what happens when GPs are trusted to adapt their services to patient need. I remember former RCGP chair Professor Helen Stokes-Lampard saying: ‘If the light bulb in my practice needs changing, one of us just changes it, we don’t need a series of delegations or committees to tell us who can, what type or precisely how to change the bulb.’
GPs have been doing much more than changing lightbulbs in the past few months. The initiatives I have heard of have been awe inspiring: redesigning surgeries to make them safe; introducing drive-through vaccinations; devising risk matrices for staff; and providing real support for shielded patients. On top of these, we’ve been inundated with positive stories, from GPs like Dr Sharon Raymond.
Of course, many of these initiatives have been borne of necessity and a lack of central support and resources. GPs only needed to source their own PPE, for example, because health authorities failed to do so. But the innovation we’ve seen would not have been possible without the partnership model.
Finally, when practices are given resources to spend as they see fit, they tend to spend them well, reconfiguring their surgeries spending only a few thousand pounds.
Such a change of mindset would be radical. It would mean the NHS stops dictating how GPs spend funding – eg, on pharmacists or social prescribers. It would mean the NHS stops telling GPs how to organise themselves – it may be they are best off within larger federations, but that would be for GPs to decide. And it would mean the NHS stops using myriad pots of funding to force practices to fulfil the latest political whims.
This pandemic has proved GPs know their patients better than anyone. So give them the freedom to provide the best possible care for those patients.
Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at firstname.lastname@example.org
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