All new GPs should be offered salaried employment as ‘primary care consultants’, suggests a new think tank report.
GP practices should also operate as ‘spokes’ to a central ‘neighbourhood health hub’, according to the Institute for Public Policy Research (IPPR).
Its new report proposes a 10-point plan reforming health and care services in order to shift towards prevention and productivity.
Currently, services are ‘failing’ to make the country healthier and more prosperous, and on the current trajectory, the UK will increasingly ‘spend more to get less’, according to the think tank.
The authors argued that reforming primary and community care should be at the centre of any shift towards a preventative service, away from a ‘treatment’ service.
However, while primary care was once considered the ‘jewel in the crown’ of the NHS, the report said it has now ‘become a focal point for public dissatisfaction’.
The action plan recognised the need to balance continuity of GP care, which is associated with lower mortality rates, with the ability to scale up primary care so that various community services can be integrated.
It said: ‘We propose an evolution in the PCN model. We recommend the “network” model is developed into a “hub and spoke” model, with a central Neighbourhood Health Hub created at the centre of every PCN.’
The proposed hubs would join up services such as mental healthcare and outpatient diagnostics, as well as take responsibility from GP practices for population health management and enhanced service provision, while practices, as spokes, can continue to focus on delivering continuity to patients.
However, the report said that GP partners’ time would still remain ‘constrained’ by the administration and stress of running a partnership.
As such, another action in the 10-point plan urged the Government to ensure all newly qualified GPs have a right to salaried employment, with pay in line with hospital consultants.
According to the authors, this should also be offered to GP partners over time, with ICSs offering to purchase any GP practice where partners take it up. However, they emphasised that ‘no partner should be forced to take up these salaried roles’.
This would make a general practice career more ‘attractive’ and ‘sustainable’ by cutting bureaucracy and enabling portfolio roles with more variety.
The report said: ‘The alternative is to allow the partnership model to decline at pace. This would risk heaping a significant administrative burden on an increasingly small number of overworked, partner GPs.
‘Worse, it could lead to partner GPs struggling to get out of their contracts and practices at retirement. This is not a viable vision for an area of healthcare as integral to the future as primary care.’
The think tank has put forward earlier versions of these proposals before the pandemic, and in June, Lord Ara Darzi, chair of the IPPR’s Commission on Health and Prosperity, argued that GP services should be brought ‘into the fold’.
More widely, the report lays out the case for reforming healthcare, drawing on modelling showing that 240,000 fewer people would have died in the decade from 2010 if the UK had an avoidable mortality rate similar to those in comparable European countries.
The IPPR claimed that its reform proposals ‘could save taxpayers up to £205bn over the next decade by freeing up growing sums each year’.
Other recommendations in the report include striking a new deal with health and care workers which focuses on ‘better take-home pay’ and ‘stronger worker rights’, as well as upgrades to digital and physical infrastructure.
Earlier this year, doctors at the BMA’s Annual Representative Meeting (ARM) voted in favour of GP practices withdrawing from PCNs next year.
However, Pulse exclusively revealed last month that NHS England has no plans to scrap PCNs.
In June, GP leaders at the BMA wrote to the Labour Party in a bid to change its position on the future of the partnership model.
There had been some confusion over Labour’s position on the GP partnership model earlier this year – with shadow health secretary Wes Streeting offering conflicting opinions.
However party leader Sir Keir Starmer made the position clear in May when he said the GP partnership model is ‘coming to an end of its life’ and that the NHS needs ‘more salaried GPs’.