The annual British Social Attitudes survey has shown satisfaction with GP services dropped to 65% in 2017, down seven percentage points compared with the previous year, in the 'biggest one-year change' since the survey began in 1983.
I'm not going to rehearse the arguments here, the persistent underfunding, the media denigration of general practice, the concept that becoming a specialist in generalsm is somehow an easier alternative than becoming an expert in a single speciality.
All those factors exist but pale into insignificance beside the tidal wave of public demand, based on the rise of radical individualism. Figures show that it is not the tsunami of elderly population which is engulfing general practice. The age group most likely to contribute to the doubling in the number of appointments per person per year are in fact the under 40s.
This quietly militant group is responsible for the demise of high-street retail, the growth in online business and it would appear the demise of the out-of-town retail park.
The challenge to general practice now is not to fight to remain tied to a 65-year-old model, which serves a significant proportion of our current population very well. The new challenge of general practice is to diversify in ways which allow us to provide generalist services through specialist channels.
If we segment our population by the preferred method of access, we will actually find those who cherish face-to-face consultations above all else, those who desire the access and familiarity of a telephone-based service and those who wonder why, given a wealth of data they collect on their mobile devices, the GP seems unable to assess them from their work place.
Now is the time for us to refuse to be pigeonholed as one-trick ponies, good at face-to-face consultations that are available via a receptionist – essentially offering all patients the same solution: ‘let me have a look at you and we can talk about it’.
Now is the timeforto general practice to demonstrate the incredible variety of approaches spread across the country. Now is the time to demonstrate the incredible variation in clinical skills between generalists. Now is time for a new model in general practice.
- Dr Chris Mimnagh is a GP in Liverpool and head of clinical innovation liaison and deployment at The Innovation Agency, the academic health science network for the north-west coast.