This site is intended for health professionals only

As another difficult year ends, GPs are facing a perfect storm

Whenever he’s asked about whatever may be the latest threat to GPs to appear over the horizon, GPC chair Dr Laurence Buckman has a favourite way of responding. ‘Is it the end of general practice as we know it?’ he asks wearily. ‘It’s always the end of general practice as we know it.’

As yet another difficult year comes to a close, many GPs feel under pressure on every front. There is the likelihood of imposed changes to the GP contract, in England at least. There will be winners and losers from the levelling out of practice funding, but for some it will be devastating. PMS practices face an uncertain future. And GPs of every stripe can look forward to an enormous hike in workload.

That the BMA is unlikely to be able to resist these changes is due partly to its defeat on pensions in the summer, and the squeeze on pensions is another of GPs’ many woes. Then there’s revalidation, the bureaucratic nightmare that is CQC registration and, to top it all, GP commissioning – with some CCGs showing signs of becoming every bit as much of a headache as PCTs are.

A perfect storm is brewing. But Dr Buckman’s point is a good one. General practice is not so much at the end of the road as at a crossroads, and events in the next few months will determine what path it takes.

What needs to happen to ensure the next year is a happier one for GPs?

Firstly, the new health secretary must seriously reassess his relationship with the profession. For all his faults, Andrew Lansley at least engaged with and appeared to understand GPs. Jeremy Hunt must appreciate that just because he finds he can unilaterally impose contract changes, it does not make it wise to do so – particularly if GPs are supposed to lead the new NHS. A little Scottish-style détente would not go amiss.

Secondly, CCGs must listen to their better angels. Some may be itching to reshape health services and impose draconian performance management measures, but they would do well to keep their members onside. Clinical commissioning will be a genuine success only if it includes GPs who don’t normally get involved in that kind of thing.

And finally, GPs across the country must find some way to unite and speak with one voice again. An LMC chair in our letters section argues convincingly that the profession has become increasingly splintered and thus impossible to lead. There is a real danger that divisions between GP commissioners and jobbing GPs, between partners and sessional doctors and between practices that will benefit from the contract changes and those that will not will become entrenched.

The next 12 months will not, with a bit of luck, bring the end of general practice as we know it. But it is going to be tough – and a little solidarity among GPs will go a long way.


Pulse in 2013

It’s not just general practice that faces a year of change in 2013 – Pulse does too.

As you’ll have already read on pages 2 and 3, we’ve got exciting plans, with everything from an iPad app to our new two-day conference for GPs, Pulse Live.

The first issue of your new-look monthly Pulse magazine will arrive in January. But in the meantime, signing up for our daily emails is free, quick and easy. If you haven’t already, I’d urge you to do so at