GPs will be tasked with preventing ill health under a set of ‘radical’ new NHS reforms, the health secretary has said.
In a lengthy speech at the Royal College of Physicians today, Sajid Javid said the Government’s ‘Road to Recovery’ plan would have a new focus on prevention with primary care at its ‘heart’.
According to Mr Javid, primary care ‘represents one of the very best ways of preventing and managing illness in the community’.
However he also acknowledged there was ‘a sense’ services were ‘too stretched’ to do so at present.
Introducing his reform plans, Mr Javid said they were ‘radical but logical next steps’, which ‘flow from the increasingly patient-centred and systems-based working through the Integrated Care Systems’.
Mr Javid said: ‘Primary care and all our GPs, pharmacists and dentists must be at the heart of this new agenda on prevention.
‘I know there is a sense that primary care is far too stretched to be proactive on prevention – even though it wants to.’
Setting out his ambition to ‘hardwire prevention into the NHS’, the health secretary suggested that ICSs will face targets and financial incentives to deliver progress on the agenda, starting with work on cardiovascular disease (CVD).
He said: ‘My department and the NHS will also work together to look at where barriers can be removed and incentives improved to focus on prevention.
‘Building on our Integration White Paper, my second commitment is to put prevention at the heart of how we hold our ICSs to account in the future.
‘We will expect NHS England and individual ICSs to commit to joint delivery plans to reduce the biggest preventable diseases – starting with cardiovascular disease, but in time, expanding to include diabetes, cancer, and poor mental health.’
He added that CVD is one of the ‘biggest risks to health’ and made a commitment to ‘push the entire health and care system harder’ on its prevention.
The health secretary also spoke about the new ‘national vaccination service’ he proposed in January to relieve GPs, but offered scant details.
He said the new GP focus on prevention will be backed by a new ‘sustainable vaccination service’ that applies lessons and technology from the Covid vaccination programme onto ‘other routine vaccinations’ such as childhood jabs.
He said the ‘new approach to vaccination’ would mean programmes do not ‘displace other health and care services’.
‘This can be a better experience for the public but will also help the NHS drive the prevention agenda forward, providing improved data that helps plan services’, he added.
And Mr Javid suggested that the NHS App will also have prevention ‘at its heart’ so it can be the ‘front door for preventative tools and services like a new digital health check’.
Setting out his reform agenda, the health secretary stressed this comes as the NHS faces some ‘long-term challenges’ including ‘rising patient expectations’ and an ‘unsustainable financial trajectory’.
He added that he is ‘looking forward’ to hearing the outcome of Claire Fuller’s ‘stocktake’ on how primary care networks can be supported within ICSs to ‘deliver for the communities they serve’, which is due to report in the coming months.
Mr Javid’s speech also confirmed that patients waiting for secondary care treatment will be given the ‘right to choose’ their provider to help tackle the Covid backlog.
His review of primary care – which was supposed to be announced at the end of February – was expected to form part of today’s announcement, but was not mentioned.
Responding to the speech, BMA council chair Dr Chaand Nagpaul said: ‘Many of the proposals articulated today lack detail and the BMA will want to careful consider how they will be delivered.
‘The Government talks about proposals to prioritise prevention, something the BMA has long called for, but has allowed the continued erosion of public health budgets and has made no effort to ensure public health leaders play a key role in Integrated Care Systems.’
Dr Nagpaul also complained that the announcement ‘omitted the most fundamental element of any recovery strategy which is tackling the chronic workforce shortages in the NHS’.
‘In general practice, the Government is set to miss its target to recruit 6,000 more GPs by 2025, with England having lost the equivalent of 1,608 fully qualified full-time GPs in the last seven years alone,’ he said.
‘The Government must now show how it will prioritise recruitment and retention otherwise patient care will continue to suffer.’
It comes as a think-tank report – backed by the health secretary – said on Friday that the majority of GPs should be employed by trusts, with the GMS contract to be phased out by 2030.
And Pulse revealed last week that Government officials have visited Royal Wolverhampton NHS Trust’s salaried GP model to explore ‘alternative ways to deliver primary care’.
READERS' COMMENTS [25]
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Genius. Put prevention at the heart of primary care – and the first thing we are going to do to achieve that is remove vaccinations. A bigger issue, might I suggest, is the day on day increase in “emergency” care from an ever growing public who can’t manage minor illness (and NO pharmacists are NOT the answer Saj!). I have just sensed my retirement date has crept a little nearer (again).
Wow. Groundbreaking. Clearly you think GPs cause ill health. And must now prevent it. Here’s to your obesity, illicit drug, depression, alcohol and boredom campaign Sajid.
Clap clap.
Keep the DNAs coming.
Radical? Really. Is that the plan? Utterly depressing in its naiivety and formulation. And all on a shoestring budget
‘Primary care is far too stretched’
No sh-t Sherlock.
It’s complete boll- -ks then.
How about an obesity tax?
Think of the health benefits and revenue.
So what I’m reading from this – is all of our appointments should be immediately switched to prevention – and the big shiny hospitals with all their new money can deal with the day to day requests and acute care.
Good plan.
Has he not heard of the Marmot reports? Or read “The Spirit Level” (Wilkinson and Pickett). Or Joseph Rowntree reports. Or plenty more similar?
It’s the fiscal policies causing poverty and stress, poor housing, benefits struggles, food policy etc etc. that are more relevant.
No, easier to blame GPs!
What is he saying that is new? Rehashing old ideas. Didn’t the government reduce the Public Health budget and split it off from the health service?
Maybe it would be a good idea to reinvest in Public Health budgets which have been slashed over the last five years Mr Javid, their key role was prevention.
As Kay says investment outside the health budget is best at preventing Ill health ( housing , education etc.) and legislation ( smoking Bans , car seat belts , water sanitation ) the most effective government interventions.
And the closest predictor of your lifetime health status is the level of education you achieve.
Not arguing for less money for General Practice , we need that to to mange the ageing population but look at the evidence for prevention.
And the dilemma for government is the healthier we are , the longer we live and eventually the more we cost the NHS that is why in the South West CCgs always overspend their budgets!
Cognitive dissonance:
1. GPs can’t be trusted, especially with more money.
2. GPs are the only ones who #SaveTheNHS by: taking over public health work; doing much of the work CMHT previously did; being the community house officer for hospital specialist nurses; taking on most of the hospital outpatient work by learning how to do each specialty via Advice & Guidance.
Successive Health Secretaries have singlehandedly solved the problem of funding the NHS – get the GPs to prevent IHD, cancer, obesity and diabetes. Couldn’t someone brief them before they take on the post? We’ve been practicing preventative medicine for 50 years and we are fighting a losing battle. You’ll need to find another way!
If there is a significant impact to be made on these issues it will be through Public Health measures – you know, that thing that is no longer funded – rather than through individual clinicians.
His speech is also full of contradictions – he states we cannot keep increasing the funding into the NHS (solution: tell the punters they can no longer get ill) but then states that access to blood tests, investigations etc should be easier for all – just order them through the NHS App.
I don’t find his vision for the future of the NHS at all credible.
He recognises that we are overstretched but will increase workload anyway. Reducing vaccinations will not help the daily workload for us in a major way but will affect our income.I am happy to do preventative medicine but who will do the acute work then, all patients to a/e
bloke’s an idiot !
Most prevention in general practice over the last decade has been in trying to ameliorate the public health harms of invidious government economic reforms.
Javid clearly doesn’t understand how it works and I suspect, doesn’t care.
These policies are the policies they always intended to implement; the basis for their introduction is whatever they think sounds best at the time.
Have we become the helpless fools that they take us for,?
The Black Report (Inequalities in Health) is over forty years old now. I wonder if Mr Javid has even heard of it? There were improvements in some areas covered, but the country’s health is deteriorating again and has been doing so markedly over the last decade or so, many of the key indicators of this being pretty much solid markers such as relative perinatal mortality and life expectancy Of course it’ll all get better with a bit more GP-flogging and some further help for the super-rich at the expense of the rest… obviously it will, Oh, dear, these people make me tired. And not a little… well, bloody furious.
Am sure the financier is very interested in the stocktake. Perhaps he thinks we can just write off all the old assets on the balance sheet and hey presto. NHS sorted can I have my old job back now?
Yawn….he is such a fool.
The usual Bull**** bingo.
GPs to work together in PCNs, based in a borough ‘place’ to help prevent ill health.
If only there were an organisation tasked with improving the ‘Health’ of the ‘Public’ based in councils. What would be a good name for such a department?
Basically what he is rebranding here is “GPs at the heart of scapegoating”.
He is so out of touch with what is happening in the real NHS.
Is he an alien?
However surely you don’t need medical training for most primary prevention ?
weight management- smoking cessation- early musculoskeletal care – gym access-mental health resilience- good housing and social care- decent education- crime prevention
With limited resources surely society needs to choose whether GPS are for preventing the medical conditions society and politicians couldn’t prevent or should concentrate on treating them? Ideally both but we can’t backfill hospital and intermediate care whilst also doing preventative work that doesn’t need medical training. Politicians need to decide. We are just their servants….unless the profession decides otherwise …,
Morons.
Primary prevention is central and local govts job. Basic public Health theory.
GPs can’t affect or effect primary prevention. Control is at govt level.
Most effective health prevention measures are primary prevention.
secondary prevention; bolting stable door after horse bolted, fairly ineffective.
Secondary prevention our remit. And we do it already.
Smoking cessation, diet and exercise advice to diabetics and the obese; non stop. Ineffective.
Because preventative medicine is about central and local govt policy and funding.
Dimbleby report. Sugar, fastfood processed food taxes; advertising bans, etc.
The only effective tools.
No. Won’t suit the big Corporate food lobbyists.
This GP health prevention BS is part of NHSE’s dumb “integration” plan.
Can see the hallmarks of managers with no medical training all over it.
And Javid is stupid enough to front up this BS.
I see Boris not taking any credit for the cunning integration plans.
Not that stupid I’m guessing.
I think this is part of what they call their horizontal integration.
Ditch the PCN DES, renegotiate the contract, Get Primary Care done.
https://www.bmj.com/content/364/bmj.l228
ha ha ha ha hahahahahahahahah
I have precisely 4 hours left after 34 years of this utter bullsh1t.
Then asta la vista baby.
Already looking at next week’s sunny forecast to go out and get some fresh air.
Bye bye to this desk-bound ideological bollock$.
Shame because in that time I have become a medical expert in so many areas.
Worked like a dog throughout.
Being a GP is like a slow death.
I wouldn’t spend a single extra minute in the hideous anachronism that is the NHS.
Can everyone rise at 8pm tonight and give me a big clap.
Thank you.