I speak to a lot of GPs, and the reaction to saying ‘GP Forward View’ in a room is often the same as if you insert yourself at the front of a long post office queue while 20 other people stand patiently in line.
Noses wrinkle, people frown, looks of displeasure abound. There is a period of unspoken suspicion while you are assessed. Are you one of those? A fervent believer? Or are you an extreme cynic?
The truth is most of us are past caring. There were loud promises made. We didn’t believe them. A year later they haven’t been kept – quelle surprise! The daily grind goes on.
Many of us may have bought into the positivity initially. Despite all past experiences, we dared to hope the tide was turning and that, maybe, the promised funding would appear. And in some areas, it has. But for a lot of us, the glimmers are hidden behind a dark cloud of bureaucracy.
Even with good guidance and a good LMC, the masterplan comes unstuck when CCGs won’t hand over the cash. Take the £3 per head of funding for CCGs to ‘provide practice transformational support’. This can be (almost) anything that helps your practice work more efficiently or with others – the Forward View could not be any clearer.
Except, somehow, this has been lost within the red of CCGs’ massive deficits. Some are simply refusing to hand the cash over. Some claim they’ve decided how it should be spent (erm, no). Some insist it’s part of baseline funding and not ringfenced. Oh, for the love of…
This embarrassing mess should have been rapidly sorted the instant the quibbling became apparent. Yet still it drags on and I can’t say strongly enough to anyone who is supporting the Forward View, if this £3 per head can’t be delivered, then any last vestiges of faith GPs have in this project will fade away.
Where the Forward View has had successes is where messages have been clear and doctors know what they should get. But these areas are few and far between. Of course, the fervent believers continue to exist in an alternative reality. I recently heard a presentation from one about the future of general practice. It was slick and detailed: I would have time for the patients that needed me and support from a multidisciplinary team. Reduced paperwork, better resources, flexible working and the prospect of finishing on time – it sounded amazing.
But that glorious nirvana lies on the other side of a perilous, crocodile-infested abyss. I am on the gloomy bank with the rest of general practice, asking, how do I get from here to there?
If you want to take normal GPs on this journey to a rosy future, start by getting the cash we’ve been promised and giving it to us. And here’s a radical idea: instead of deriding the sessional GP workforce, why not talk to them and centrally fund clinical backfill, to give overworked partners the breathing space they need? Otherwise we’ll all just be left staring into that abyss.
Why am I having to explain this? It isn’t rocket science. But then no one thought updating IT security was rocket science, and look where that got us….
Dr Zoe Norris is a GP in Hull
