Generalist role 'under threat'

The generalist role of GPs could be lost if the shift of secondary care to the community goes ahead, say UK researchers.

Dr Richard Vautrey
A report into the first year of 30 demonstration sites providing care closer to home highlighted concerns that as more GPSIs are hired to carry out the work, the remit of other GPs will decline, reducing their generalist capabilities.

The comments came from those involved in 30 pilots of providing dermatology, ENT, general surgery, gynaecology, orthopaedics and urology in the community.

The services were set up in response to recommendations in the White Paper ‘Our Health, Our Care, Our Say’, published in February 2006.

Following analysis of outcomes from September 2006 to May 2007, the National Primary Care Research and Development Centre (NPCRDC) in Manchester said: ‘Comments were made that the development of GPSIs could either up-skill or deskill existing GPs.

‘They could deskill them by taking existing routine care out of general practice (possibly appropriately) leaving GPs with a more restricted workload.’

Dr Richard Vautrey, GPC deputy chairman, agreed the generalist role may be at risk. ‘If specialism is seen as more worthy than a generalist approach, there is a risk of this. There’s a real tension about how you preserve the generalist role and support those who want to be a specialist. The key is to be generalist first, specialist second.’

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