Londonwide LMCs chief executive Dr Michelle Drage called for an end to 'fake models of care' and for GPs to lead service transformation on their own terms.
Speaking at the Londonwide LMCs annual conference at the Emirates Stadium in north London, Dr Drage said the multispecialty community provider (MCP) model looked set to be the delivery vehicle for the NHS sustainability and transformation plan (STP) process, but warned it could divert resources from the frontline.
Dr Drage told GPs that 46% of practices in the capital reported at least one vacancy, while 45% have at least one GP planning to retire in the next three years, while high levels of deprivation and rising population continue to push up workload.
'Last year we declared a state of emergency,' said Dr Drage. 'That state of emergency continues.'
The LMC chief said that analysis showed the benefits of co-ordinated community care, with a 1% increase in community service funding leading to a 3% reduction in emergency attendances. But she said the NHS Five Year Forward View agenda was to fit general practice into the MCP and STP structures.
'New models of care, led by political imperatives rather than evidence, pushed by the stick of contract changes and the carrot of funding streams,' she said. 'The ambition of providing care at scale results in the at-scale part taking up all the resource and the providing care part coming in second place. We cannot have that.'
Dr Drage called on GPs to find a 'better way'. 'If we are to transform, let us not do it at the expense of our values,' she said.
'Shouldn't we be doing it like this: allowing services to connect across boundaries. GPs, community services, third sector and local groups, schools, and everybody else ... working across boundaries. Giving GP practices the autonomy to meet the needs of their populations consistent with the values of general practice.'
Dr Drage added: 'Form must follow function. So let's stop faffing around creating fake models of care. The things you do daily, that is what creates improvement and innovation. Plans in the sky just drive more plans.'