The ‘Uberisation’ of general practice – with continuity being lost in favour of convenience – is the wrong way to go and will harm patient safety and care, former health secretary Jeremy Hunt has said.
The chair of the House of Commons health and social care committee also reflected on his own time as health secretary, admitting his flagship ‘named GP’ policy failed to have an impact.
Speaking at an emergency press conference for the campaign, Mr Hunt said that moving away from continuity of care is a ‘big mistake’, but there needs to be ‘more capacity in the system’.
He said: ‘I’m afraid we’re moving towards the Uberisation of general practice where you see a different GP every time you contact the NHS, just like you see a different Uber driver. That cannot be a good thing for safety and care.’
‘I personally think it’s a big mistake to move away from continuity of care.’
Reflecting on his time as health secretary, Mr Hunt said the ‘big lesson’ was to have ‘a longer-term approach to workforce planning’.
He said: ‘One other thing I wish I had done more on is this issue of continuity of care, so that everyone has their own GP, negotiated with [GPs].
‘The result was a lot of GP surgeries sent out a letter to their patients saying, your GP is Dr X. And then everything carried on as normal. No real change happened.’
He added: ‘We won’t address that issue until we have more capacity in the system. And that is why I think increasing the capacity of general practice is the biggest [issue].’
Oxford GP Dr Rachel Ward added that for some things, seeing anyone in the practice is appropriate.
She said: ‘If you have a minor ailment, or a limited acute illness, actually, I think it is fine to see your GP or nurse practitioner or paramedic in the practice.
‘But the patients who have multiple medical problems, patients who have complex social issues, mental health problems, they like that continuity, and actually as GPs we like our continuity too.
She added: ‘It’s a much more interesting job, when you see a patient through their journey, when they’re struggling to start with and you bring them through, there’s nothing more rewarding than that.
‘But at the moment, we get more complaints than we’ve ever had in my practice, which is very disheartening, very sad to see that we’re not offering patients what they need. A lot of it is about availability of appointments.’
It comes as Mr Hunt recently suggested GPs should have their own list of patients, which Sajid Javid said would be ‘a common-sense approach’, during a House of Commons Health and Social Care Committee hearing for its ongoing inquiry into the future of general practice.
Mr Hunt’s own flagship policy for every patient to have a named GP – introduced during his tenure as health secretary with the 2014/15 and 2015/16 GP contracts – were found by researchers to have failed at improving continuity of care.
A study review published in the BMJ Open in 2019 found that continuity of care did not improve, and hospital admissions did not decrease, calling for more ‘sophisticated’ interventions to be made instead.
Meanwhile, a Norwegian study, published in the BJGP in October last year, found long-term continuity of GP care to be ‘strongly associated’ with lower mortality, reduced need for acute hospitalisations and reduced use of out-of-hours services in the general population.
In 2015, then health secretary Mr Hunt promised to add at least 10,000 extra primary care staff, including 5,000 GPs, within five years.
But official workforce figures revealed the NHS actually lost 1,000 full-time equivalent GPs between the initial pledge and March 2018.
Chair of grassroots campaign group GP Survival Dr John Hughes told Pulse: ‘It is a little ironic to see Jeremy Hunt castigating the Government over workforce issues, when in his own time as health secretary he utterly failed to make any changes to the workforce crisis.’