Previews of the year: More of the same, I’m afraid

It is remarkably difficult to make predictions about the year ahead for general practice in the continued wake of the Covid-19 pandemic. 

Recent weeks have made it clear that Covid may yet have a sting in its tail. Whether the virus inflicts significant pressure on the NHS or not (I suspect Covid might be the least of our worries in the coming year), our reaction is bound to. From infection control measures, soaring waiting lists, reduced capacity in secondary care and vaccination pressures, to the impact of testing and isolating on the public and healthcare professionals, I predict we will face an exceedingly challenging year. 

It will be a year in which opposing factions continue to call for very different approaches to managing this virus. I suspect the media, politicians and healthcare leaders will continue to obsess about Covid, while the physical and mental health of the nation worsens. 

Life expectancy will fall, cancer survival statistics will worsen and rates of mental health problems will increase. Waiting lists will lengthen and the isolation of our patients, their economic hardship, and lack of community and secondary care support will combine to markedly increase demand for GP time.

Our full-time-equivalent numbers will continue to decline, as more GPs find ways to reduce their clinical commitments in the face of the unmanageable pressures. A wave of retirements is also bound to unfold, following the stress of the past two years. In turn, our patients will find it harder to access a GP – the ongoing denigration of our profession by the press will be an unavoidable result.

Let’s not kid ourselves – NHS England will not provide any meaningful package of support, or changes to improve our service or bolster the workforce. 

The battle lines between the BMA and NHS England will remain, with the former lacking focus and a clear direction from the profession, and the latter loath to be seen to be giving more money to greedy doctors. Unfortunately, in this stalemate, hardworking GPs will find themselves propping up an increasingly substandard and frankly dangerous health service. LMCs are displaying increasing discontent with the PCN model, and we may begin to see the unravelling of this project.

Fundamentally, I predict 2022 will see us dealing with the death throes of a crumbling NHS, and the outcomes are unlikely to be pretty. I’m genuinely sorry I can’t provide a more positive spin – but Happy New Year anyhow! 

Dr Katie Musgrave is a GP in Devon