Dr Berwick may be deputy medical director of NHS England, but he has yet to learn how to toe the party line.
He was a GP principal in Cumbria for 20 years and seems to have retained his Northern frankness, declaring primary care commissioning ‘a mess’ and that NHS England was ‘almost burying head in the sand’ on the GP workforce crisis.
Having said that, Dr Berwick is not afraid of speaking hard truths to GPs, such as setting out new standards for in-hours closing that included telephone access on training days.
As lead for long-term conditions, he says his role is complicated by the pressures facing general practice currently and that he would have liked to see more progress on rebalancing funding between secondary and primary care.
But he says that he wishes that people would more often give the benefit of the doubt and not jump to ‘premature conclusions’.
After his first year at NHS England has past, he points to the ‘Call to Action’ consultation as a particular success. He says: ‘I’ve been struck by how that’s encompassed not just general practice but the whole of primary care.’
Dr Bewick says there will have to be shifts from traditional models in terms of contracts and how funding is divvied up. Future resources, he says ‘have got to be based on the needs of the population’. ‘We need to define what organisations will do on a population basis not an historical basis,’ he says.
The stand out moment of the year for him has been the NHS being declared the best healthcare system by a Commonwealth Fund report. He says: ‘It was the recognition that NHS England with its resources is the most accessible healthcare system in the world. That a publically funded NHS is a real strength.’