RCGP chair targets the GP Forward View

Outgoing RCGP chair Professor Maureen Baker reflects on the work still to be done to secure the future of general practice.

RCGP chair Professor Maureen Baker
RCGP chair Professor Maureen Baker

The final months of Professor Maureen Baker’s tenure as chair of the RCGP will be intensely focused on ensuring that the pledges of the GP Forward View are fully implemented.

Having led the college to securing this £2.4bn uplift for general practice, Professor Baker has been concerned that the new leadership of the Conservative government could have different priorities to David Cameron’s.

‘We feel it’s the right plan, but as yet it’s largely just a plan and a key job for the college now is to ensure that the plan is implemented,’ she says.

‘My focus while I am still chair is to seek commitment to the GP Forward View from the new government. We have been trying hard to explain why we need this plan and make the case that just responding to difficulties in the acute sector is not the best way of funding healthcare.’

Ensuring GPs have a strong say

Professor Baker steps down in mid-November, with current honorary treasurer Dr Helen Stokes-Lampard taking over the post of chair and the lead role in ensuring that GPs have a strong say in the implementation.

Professor Baker warns of concerns that not all of the new NHS initiatives are heading in the best direction for general practice.

‘There is still this tension around ensuring that the generalist voice is heard in decision-making across the wider health economy, for example on the sustainability and transformation plans (STPs). If they do not shift the focus from acute trusts, we will be no further forward than before.

‘The ethos behind the Five Year Forward View and GP Forward View is about changing the
way we deliver healthcare and enhancing the role of primary care and general practice, and the college is now very actively engaging with STPs to ensure these points are clearly made.’

Professor Baker is certain that these major new funding initiatives would not have happened without the public support generated for GPs by the RCGP’s awareness campaign, Put Patients First: Back General Practice.

A college petition signed by more than 330,000 people prompted a debate in parliament and won almost unanimous support for the campaign from MPs.

‘MPs know their constituents value general practice, but the problem is with access. The campaign showed that GPs had responded magnificently to the challenge of increasing demand, against a background of increasing complexity of work and decreasing funding. We were able to clearly make the case that it was not a problem of GPs not working hard enough,’ she says.

A key part of strengthening general practice over the next five years is to facilitate the growth of collaborative working between practices, although she is clear that there is no obligation for GPs to take part.

‘Most practices in England relate to a federation or collaborative structure because they find it’s the best way to respond to current challenges, but if some do not want to do that, it’s fine.

‘Where practices are working together in collaboration and adding value to the local health economy, it’s in everyone’s interests to ensure they are well set up, well-resourced and well-integrated into the local structures.’

Developing the skill mix within practices is also an important part of the plan, encouraging the employment of more nurse practitioners and practice-based pharmacists to relieve the burden of workload on GPs.

‘Pharmacists can take on a lot of valuable tasks within the practice that are very time-consuming for GPs, such as medicines reviews and work on formularies, and there is good evidence that using pharmacists in this way brings very valuable skills into the practice.’

The college is less keen on expanding numbers of physician associates: ‘We are sceptical because the evidence is not there. This was tried in the early 2000s and did not take off, for whatever reason, so we are not sure whether doing the same thing again will lead to a different outcome. But if practices choose to employ a physician associate and it’s valuable for them, that’s great.’

New technology

More effective use of new technology in general practice is also seen as a means of reducing GP workload, while at the same time enhancing the patient experience.

The RCGP will deliver that message in fringe meetings at the political party conferences this year.

Although high-profile public appearances are a major part of the daily life of the RCGP chair, Professor Baker cites her work on the less visible college policy papers as one of her proudest achievements.

Over her three-year term, the college has tackled topics such as patient-centred care, continuity of care, patient safety, implications of professional fatigue and health inequalities.

‘We have produced a slew of policy papers which now represent a comprehensive body of work. I always wanted to address the wicked questions of the time and I’m really pleased that we have been able to get those papers through. In terms of building the discipline of general practice, it’s something I’m really proud of.’

She says chairing the RCGP has been ‘a great privilege and the pinnacle of my professional career’, but a tough job, nonetheless.

‘You are very exposed as chair. You put your head above the parapet and, frankly, you get some abuse. But the vast majority of people I come into contact with are wonderful people who are going the extra mile for patients and the NHS, and it’s fantastic to think that you are helping to make a difference for them.’

The speech
Professor Baker’s keynote speech to the RCGP Annual Conference will this year focus on the theme of leadership, drawing on examples from literature and popular culture, including Star Wars.

‘I’ll be considering where leadership can sometimes take us. Leadership is fine if it takes us to the right place – when it’s leadership with the right idea, not the wrong idea. But there are potential dangers in there. What do we have to guide us? How do we know that we are going in the right direction?’

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