I am struck by the fact that we do not see the whole picture when making budget decisions.
We are doing lots of work helping general practice and CCGs improving care for patients with long term conditions. There is lots that we can do to for example keep patients out of hospital. It will concern me if we don’t think about this when making budget decisions.
This is really a very pressured time for general practice at the moment. But for me it also emphasises just how important it is to work more efficiently and to look at how we can cooperate more between practices - this is a largely untapped area for general practice. The only other option to fall back on is to work harder but I think most of us are already working as hard as we can do.
We need to ask ourselves: How can we work as efficiently as we can do and collaborate as much as possible across practices? There are lots of different ways of doing this, from federating to having joint service arrangements. There are lots of ideas but what structure you choose is probably less important than the fact that practices are collaborating. We need to look at how we can collaborate on a clinical level, at patient level, but also making use of economies of scale.
It is always lovely if we can have more money but I am not sure how much more money the NHS has to spend at the moment. But what is encouraging to me at the moment is the interest we are seeing from CCGs and local area teams in how general practice can really achieve a lot of the improvements that are needed in the NHS - for example with regards to managing long-term conditions.
By now, we all know that general practice is good value for money and I think that CCGs, at a local level, will therefore invest in general practice.
Dr Robert Varnam PhD MRCGP is clinical lead for primary care & commissioning at the NHS Institute for Innovation and Improvement