As part of the Pulse in Print series looking at the current state of the profession, columnist Dr Katie Musgrave provides a dose of sober realism
Reflecting on where general practice finds itself in 500 words is akin to summarising Shakespeare’s complete works on the back of an envelope.
Should I mention the low morale, poor retention, early retirements, or burned-out GPs reducing clinical sessions? Should I focus on funding for allied staff, but not for highly trained, experienced GPs? Dare I reference the fall in partnership income, and the inevitable reflections of many partners – how long can I continue like this? Is it really worth it? Can I mention spiralling workload (hospitals sending increasingly ludicrous requests yet never seeing our referrals, and 111 treating practices as mini A&Es)? And where to start with the endless bureaucracy?
Remote consultation seems here to stay, with more practices shifting towards online triage, which is celebrated as facilitating signposting or self-care advice, while ensuring the patient sees the right person at the right time. We wait to see if this leads to yet more demand. How will such changes affect access for the frailest or those who experience digital exclusion? Quality and access seem to vary quite widely.
The PCN project remains a nebulous beast, largely not impacting our day-to-day operations, but steadily changing workforce structures. Apparently, they offer no end of unfulfilled opportunities.
One dares not think what NHS England is doing while practices flounder and abandon hope of any meaningful support or uplift in core funding. Last year’s contract imposition suggests NHSE is oblivious to the strain GPs are under, and has no plans to increase our share of funding.
However, the BMA is sounding unusually robust and coherent, arguing for continuity, manageable workloads, and the valuing of expert generalists. Could we see more positive changes in time?
Finally, we’re nearing a political turning point, with the Conservatives looking set to lose power to Labour. Sadly, neither party seems to have any sensible ideas to address the crumbling state of UK general practice.
We appear to be up the proverbial creek. Who packed the paddle?
Dr Katie Musgrave is a GP in Devonshire
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‘akin to summarising Shakespeare’s complete works on the back of an envelope’
Try, ‘For he’s a jolly good fellow;