Neighbourhood services should never replace core general practice, says RCGP
Neighbourhood services should never replace core general practice and the Government must commit to implementing a ‘primary care investment standard’, the RCGP has said.
The college said that the Government must ‘recognise’ the role of general practice in the new model, as part of a new position paper on neighbourhood health.
It said that GPs must play ‘a central role’ in shaping neighbourhood and community services and pathways, informed by their ‘unique’ understanding of patient journeys, unmet need, multimorbidity and how services and systems function in practice.
It reinforced its call for the implementation of a primary care investment standard, requiring the Government and ICBs to report on the proportion of their spending going to general practice each year.
The RCGP had already called for the standard to be included in the 10-year plan, to fulfil the Government’s ambition to shift care from hospitals into the community.
The paper concluded that successful neighbourhood services will depend upon the development of ‘trusted relationships’ across the NHS and that general practice provides ‘an essential foundation for this model’.
It said: ‘General practice brings expertise in medical generalism, clinical decision-making under uncertainty, and the integration of care across multiple conditions, services and stages of illness – all essential features of effective neighbourhood and community models.
‘Neighbourhood and community services should build upon, rather than replace, core general practice.
‘As care shifts into the community, resources must move with it. Neighbourhood and community working will only be sustainable if accompanied by resource transfer and a sufficient overall uplift of funding into the community. This should include the implementation of a Primary Care Investment Standard, requiring both central government and local systems to report on the proportion of their spending going to general practice and primary care each year.’
In a message to GPs, RCGP president Professor Victoria Tzortziou Brown said: ‘The unique contribution of GPs is our ability to provide expert medical generalism, manage complexity and uncertainty, integrate care around the whole person, and build trusted relationships with patients over time.
‘Neighbourhood care has enormous potential, but it must be built on strong, sustainable general practice.’
Pulse has contacted the Department of Health and Social Care for comment.
It comes as neighbourhood contracts which were announced as part of the 10-year plan and were expected at the end of last year have not been published yet.
NHS England previously said that the new contracts will be developed during this financial year, but its lead for neighbourhood health recently could not commit to a specific timeline for the contracts.
Last week, the new BMA GP committee chair told Pulse that it is ‘completely necessary’ that partnerships are protected within the neighbourhood health model.
The union raised concerns that the roles of PCNs and GP federations within the new model ‘remain unclear’, creating ‘considerable uncertainty’ and some ICBs have already chosen trusts – rather than GP practices – to lead their neighbourhood models.
And earlier this month, every GP practice in Kent and Medway signed up to a ‘neighbourhood’ care model using existing PCN contract arrangements, the first of its kind.
