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Creating a shared vision for general practice in London

Like anyone starting a new job I’m experiencing a great sense of excitement, both at the prospect of bringing about real change for patients across London but also at getting to grips with the challenges involved. The task ahead of me and the team at NHS England is to support the transformation of primary care services across London – and to secure a sustainable model of general practice for the future.

This is a newly created post, intended to build on the work already happening in STPs and CCGs across the Capital to develop new models of care. My role will be to provide additional clinical leadership for primary care transformation and the digital agenda in the NHS in London.

My concern about trying to describe a specific vision for the future of general practice is that it implies there should be a single solution for over 1,400 practices in London. The diversity of our population will necessitate some local variation in approach. We cannot create a one-size-fits-all model, although I think there are some principles that can help ensure consistency of quality, despite differences in delivery.

However, I don’t want to give the impression that I’m already of a fixed view and the task is simply to roll this out across London. This would be to completely misunderstand both the scale of the challenge we face and the quality of leadership that already exists in primary care.

My role should be as an ‘enabler’ – helping to create a shared vision for primary care in the Capital, which recognises the differences between the communities we serve and, where there are opportunities to do things once for London, ensuring that we make the most of these.

General practice has a long record of imaginative, adaptable leadership – and I have no doubt that together we will meet the challenges currently faced by the health and social care system with the same sense of dedication and commitment to patient care that has resulted in the comprehensive, trusted service that we have today.

We all know the NHS is under enormous financial pressure, the workforce is stretched, and the demands on every part of the health service continue to grow. Importantly general practice is widely recognised as being part of the solution. Not only does an accessible, comprehensive primary care service result in better health outcomes, it is also associated with a lower total cost of health services. Demographic changes and technological advances mean that, like every other industry, we must be prepared to adapt to a world of changing need, increased complexity, escalating demand, and heightened expectation.

From this perspective I am excited about the digital aspect of this new role, and the very real benefits that can be derived from collecting, sharing, and analysing population based data in a more systematic way. This data will empower patients and carers, and support more precise, patient-centred care. We want to enable more collaborative, multidisciplinary working between health and social care professionals, and simplify and streamline workflow within practices.

There are understandable concerns about sharing information and we must have an open, well informed conversation with Londoners about the importance of linking up data in a safe and carefully regulated manner. The aim is to reimagine the way in which we deliver care, and provide services that are more consistent, personalised and proactive.

I have no doubt that general practice will continue to lead the way in both innovation and value. To do this, we need to work more collaboratively, and we must protect the principle of an accessible, comprehensive and population-oriented, high quality primary care service – while recognising the opportunity that working at greater scale can offer. As a very wise friend once told me, we must learn to be both big and small at the same time. The insights and understanding that more consistent use of data and analytics offers is the key to us being able to do just that.

Dr Jonty Heaversedge is NHS England medical director for primary care and digital transformation in London and chair of NHS Southwark CCG



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