The National Association of Primary Care (NAPC) is working with NHS England to set out a multi-specialty community provider model called the ‘primary care home’, under the Five Year Forward View reforms.
NAPC president Dr James Kingsland told delegates at the Commissioning Show in London that the plan involved GPs working within a multi-disciplinary team covering a registered patient list of between 25,000 and 50,000.
‘I think most general practices recognise that a GP, practice nurse, and an administrative team might have been fit for the 20th century but may not be the vehicle for 21st century care,' he said.
The best of traditional general practice
‘We are not dismantling what is seen as traditional family medicine from general practice. The building blocks remain but we need to scale up a little bit.’
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Dr Kingsland said the size of the organisation would be limited: ‘We believe that once you go over a registered list size of 50,000 then you lose some of the personalisation, the continuum, and the interactions within the primary care team.
‘So we are talking about an organisation that might be 25,000-50,000 registered patients and get the best of traditional general practice, scaled up, a multi-disciplinary service, and more finished episodes of care out of hospital - which is the agenda, of course, for the future of the NHS.’
Dr Kingsland said one of the aims was to bring together services on one site: ‘It sometimes seems that we have become a brokery service from the patient’s first point of contact in general practice to then seeing the physiotherapist or the district nurse or the third sector.
GP training and recruitment
'We are saying with this new model that we should have the multi-disciplinary service at the point of access. Patients who register with this organisation should expect more, have more made for them and less bought for them from elsewhere.’
NAPC co-chairman Dr Nav Chana said the new model would also be important for training and recruitment: ‘We are talking about a multi-professional team with generalists and specialists working together with access to diagnostics, community service integration, and mental health being sorted out.
‘That’s the kind of environment where the majority of care should be provided and the majority of training and supervision should also be provided. We want to create environments where students can work and learn in a much more meaningful way of the wonders of working in a primary care setting.’