RCGP chairwoman Dr Maureen Baker welcomed recognition in the report - which has promised extra funding would be funnelled into primary care - that general practice was one of the greatest strengths of the NHS, and that it had remained under-resourced compared to hospitals.
She said: ‘We hope that the publication of this report will prove to be the moment that, as a nation, we stared into the abyss and decided that general practice had to be saved from extinction.'
GPC deputy chairman Dr Richard Vautrey criticised a lack of detail in the plans. 'We’ve heard talk about investment in general practice for many years,' he said. 'We’ve got a crisis now and we need resourcing now.'
New models of care
The Five year forward view report set out several new models for organising NHS care, which local areas will be able to adopt based on what most suits their local needs.
These could see practices integrating with hospitals to create ‘primary and acute care systems’ in some areas and GPs working with nurses, hospital specialists and other community health services to form multispeciality out-of-hospital care providers in others.
Dr Baker said the RCGP ‘strongly supported’ the need for new models of care, ‘particularly for GP practices to work within federations’.
‘However,’ she added, ‘models under which GPs are made employees of hospitals – and therefore can no longer independently advocate for their patients – should only be considered where there is clear agreement across the local health economy that this is the best solution and that GPs feel this will benefit general practice and patients in that locality.’
Dr Vautrey also welcomed the proposals to allow GPs to work closer with other health providers, but with the same warning.
He said: ‘On new ways of working, the BMA has already been supporting groups of practices who are working together in larger structures. However, there is no one perfect model for this and one size does not fit all. The same applies to hospitals taking over GP practices.
‘This may be the only possible option for some practices struggling to remain viable – such as a small number of remote, rural GP practices, but there is little evidence that this is needed or necessary for most of the country and could make matters worse for patients rather than improve services.’
Politicians must take note
Dr Baker urged all three major political parties to work with NHS England to set out a roadmap for how they would implement the recommendations of this ‘powerful report’. This was echoed by Dr Vautrey, who called for politicians ‘to act urgently to deliver its proposals’.
The report marked the first time the NHS has set out its own plan for the future. David Bennett, chief executive of Monitor, one of the NHS groups behind the report, made a ‘plea to all parties not to pursue further top-down change and support the changes’ suggested in the forward view.
