Speaking at a Nuffield Trust conference, the NHS England chief executive said that while GPs have their ‘backs against the wall’ they had to recognise that there must be changes in return for a reversal in underinvestment.
Responding to an appeal from from GP and National Association of Primary Care (NAPC) president Dr James Kingsland to ensure ‘parity of esteem’ between primary and secondary care, Mr Stevens said: ‘I would regard myself as probably the most pro-primary care/GP national NHS figure there has been, possibly ever.’
He added: ‘The fact is there is a deal on offer here, isn't there. Which is that, yes, we are going to actually now try and redress a decade’s worth of relative underinvestment in primary care. But, the quid pro quo is there has got to be significant changes in the way that the model works. And I think that GPs, for the most part, are up for that.’
The NHS chief executive's comments mirror a recent warning from RCGP chair Dr Helen Stokes-Lampard that GPs needed to accept that change is inevitable.
Mr Stevens' claim to be the most pro-GP NHS chief executive also echoes a claim at last year's RCGP conference from NHS England director of primary care Dr Arvind Madan that the current NHS leadership was the most GP-friendly ever.
Mr Stevens told the Nuffield Trust event that part of the solution for primary care was the NAPC’s Primary Care Home model, which provides personlised, integrated out-of-hospital care for defined, registered populations of 30,000 to 50,000 with shared, capitated budgets.
Mr Stevens defended NHS England’s primary care workforce strategy. GP vocational trainee numbers were going up, he said.
‘The issue is can we give enough hope and support for people in their 50s and 60s that the retention issue we do better there. And, can we get more flexible for people returning to work who have taken time out, maybe for children or other reasons, mid career.
‘There is actually an agreed plan of action with the RCGP, with the GPC, on all of those fronts.’
He added: ‘But over and above GPs numbers per se we are also, unusually, making some direct investments and expanding the multidisciplinary primary care team. So, NHS England is directly co-funding 300 new mental health therapists embedded in primary care.
'We are funding another 1,500 clinical pharmacists on top of the 450 or so we have out into the system, embedded in primary care, but each of these are on the basis that practices are working with their neighbours, so we are trying to use this to create some sort of centripetal forces, if you like, to bring people together in a more scaled way. So I think we will by 2020 have a substantially larger primary care workforce that we have got now.’