When is a review not actually a review? A review is only meaningful if it results in necessary change. And if the interim report of the Partnership Review, led by Wessex LMCs chief executive Dr Nigel Watson, is anything to go by, then I doubt very much that necessary and meaningful change will happen as a result.
The optimist would say this review is taking place because the RCGP, BMA, Department of Health and NHS England were all concerned about the state of the GP workforce and whether the partnership model is sustainable. The cynic would suggest the review was instigated in response to the report of the House of Lords Committee into NHS Sustainability.
Many GPs wouldn’t have got past their first recommendation, which was to overhaul the GP partnership model as it was deemed no longer fit for purpose. This may or may not have had anything to do with the way senior GPs answered the Committee’s questions about general practice and their vision of its future.
It seems to be an expensive way of saying, ‘Whoops, that’s not what we really meant, we really like you GP partners, really we do’. So the purpose of the review has never been to explore the alternative options around GP partnership, but a way of giving it a morale boost, an injection, or in the words of the interim report, ‘to make recommendations to revitalise the partnership model of general practice’.
I can confidently predict it will conclude that the partnership model needs a bit of tweaking rather than overhauling
Our LMCs are, by and large, ardent supporters and advocates of the partnership model. They exist to support the business of general practice. Not to question Dr Watson’s motives in this, which I am sure are perfectly honourable, but if you want to carry out a review that isn’t going to examine meaningful alternatives to the partnership model, then there can be no better person to appoint to lead that review than an LMC chief executive.
So, I can confidently predict that Dr Watson and his team will hear from plenty of GP partners and ex-GP partners and conclude that the partnership model is a good thing or was a good thing, but needs a bit of tweaking here and there rather than overhauling. It is telling that the key issues highlighted by the interim report are workload, workforce and risk. You’ll note that over-regulation and funding are not listed as primary concerns.
The opportunity to explore what does and doesn’t work in primary care in other health economies will slide by until the next loss of confidence in the model occurs. So, a partnership advocate will complete a partnership review, in which this is the only model he has been asked to look at, and conclude (for that is what he was asked to do) that the partnership model is the only way forward. I’ll eat this blog if it doesn’t.
Dr Samir Dawlatly is a GP partner in Birmingham