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How might general practice look in 2050?



For many practices, planning more than one month ahead is impossible at the moment.

With the current pressures on the service, many doubt whether their practice can survive the next five years and accountants’ predictions for earnings over the next year make sobering reading.

Against that backdrop, I realise it may – at first glance – seem a little naive to start a discussion about what the profession may look like in 2050. But that is what we are kicking off this week in Pulse.

Why? Because at a time of stress, it is tempting to drop anchor, batten down the hatches and wait for the storm to pass. General practice feels buffeted from all sides at the moment so the profession’s instinct may be to narrow, rather than widen, its horizons.

And with good reason. Successive governments have seemed to do their utmost to undermine the profession, at times actively participating in its denigration and maligning its place in the NHS. Systematic underfunding and a failure to plan adequately for the future has resulted in a major crisis of workload and morale in general practice. Something that may take years to heal, even if there is the political will to reverse it.

But there has to be a future for the profession. The relationship GPs have with their patients continues to be the most popular part of the NHS, according to 2014 figures published by the King’s Fund, and is acknowledged by all but the most cynical as the bedrock of the whole system. Yet the UK population is surviving longer and in the future patients will present with more complex, long-term conditions that require sophisticated management and support in the community. Something has to bridge that gap.

So we asked a group of GPs and other experts to speculate on what the service might look like in 2050. We wanted a glimpse of the prospects for medicine, practice premises and being a generalist doctor in 35 years’ time.

Far from predicting Armageddon, many came up with inspired applications for technology that is being developed now. The ideas range from the increasing use of avatars to the rise of personalised care guided by genomic medicine. It shows that, given adequate resources and the headroom to think laterally, there is plenty of enthusiasm for strengthening general practice and developing new ways to interact with patients and improve patient care.

And in all the responses we received, one thing rang clear amid the whizz-bang solutions. An unshakeable principle that will remain at the heart of general practice even in 35 years’ time. Everyone agreed that nothing can replace the time-honoured face-to-face GP consultation as the central pillar of how patients access the NHS and discuss their diagnosis and treatment. And that – in this time of great uncertainty – must be a good sign.

Nigel Praities is editor of Pulse