Many GPs have long been heavily involved in work outside standard general practice. They have taken on additional responsibility through management roles in primary care organisations and played a key part in developing services through practice-based commissioning and its predecessors.
But the formal establishment of clinical commissioning groups (CCGs) puts in place a system that will require more GPs than ever to take on roles outside their day job.
Workforce figures published last week by the NHS Information Centre show that although the GP workforce has increased sharply over the past decade or so, growth has now flatlined. This workforce is ageing, with more than 10% of GPs in England (and close to one in five in London) aged over 60.
Contribution of GPs
GP reports this week on the valuable contribution to clinical knowledge being made by GPs in Devon leading research into inter-arm BP variation. It is vital that asking GPs to find time to take broad leadership roles does not diminish the contribution they make to research.
It would be ironic too if in handing CCGs power to commission local services from specialist GPs, a key part of the drive to move work out of hospitals, the NHS left practices shorn of the staff to provide such services.
Senior GPs could also struggle to manage their practices in the face of pay freezes and tightening targets while taking on the extra responsibility of CCGs.
As the Bill went through, the BMA warned of a 'sad day' for the NHS and of the impact competition would have. But it also pointed out that GPs have an opportunity to use their role to limit that impact. This is surely the hope the profession must cling to.