Current NHS leadership 'most general practice-friendly ever', says top GP

GPs are currently working under the most general practice-friendly leadership that the NHS has ever seen, according to NHS England's director of primary care.

Speaking at the RCGP conference in Harrogate on Thursday, NHS England director of primary care Dr Arvind Madan spelled out the range of investment underway as part of the GP Forward View.

Practice closures were a 'tragedy', he said, and stopping practices handing back their contracts for 'reasons beyond their control' was NHS England's first priority under primary care investment plans.

He said the GP Forward View had been described as 'the biggest change management programme in the history of general practice', and highlighted that reform on this scale had been made necessary by a decade of underinvestment, insufficient workforce, steadily increasing demand and GP morale that was now at its lowest level 'since records began in 2001'.

GP investment

But Dr Madan argued that NHS plans to increase investment in general practice by £2.4bn a year were a huge show of confidence in the future of the profession.

He told the conference: 'I don’t think we should underestimate what a real vote of confidence this is in general practice. While I understand the concerns about CCGs' ability to invest, I would argue that we are currently working under the most general practice-friendly leadership that the NHS has ever seen.'

Dr Madan said the plans had been drawn up largely in consultation with the profession, and that he was confident GPs could manage the reform. 'GPs have an unrivalled capacity for adopting and adapting to change,' he said.

Dr Madan spelled out the two key elements of the GP Forward View. 'Our first priority over the coming year has to be to stabilise general practice. It has to be to stop practices handing back contracts for resaons beyond their control - each closure scenario is a tragedy for patients, practices and for everyone.

GP demand

'It also needs to transform services if we are to get ahead of ever spiralling demand. We need to leapfrog through evolutionary steps in development and move into a space where we can give patients a better experience and improve outcomes and equality and find our way back to more manageable working days for GPs.'

Dr Madan also suggested that general practice should move away from small-scale incentives. 'We need to move away from the system of micro-incentives in how we manage general practice, and move towards a more holistic system of care,' he said.

But in a passage of his speech that drew applause from RCGP conference delegates, he added: 'We must never in all this re-engineering forget our USP as GPs – we offer complex co-ordinated care in a patient-centred manner, and in a person-centred manner to patients with undifferentiated illness at scale, and we must never lose the magic that happens between doctors and patients in the consulting room in all the changes.'

Dr Madan admitted that the NHS had been too slow to deliver support to some struggling practices and to invest in NHS infrastructure.

But he highlighted efforts to improve GP recruitment through bursaries, medical indemnity funding and measures to address soaring workload. The NHS would seek to change the threshold at which patients seek support for self-limiting illness to ease pressure on general practice, and to increase skill mix and opportunities for practices to collaborate to ease pressure.

He added that the GP Forward View was 'to some extent the profession's plan' put together by people who believed that general practice was 'too important to patients and to the survival of the NHS to be allowed to fail'.

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