With negotiations over changes to the GP contract for 2014/15 continuing, Developing General Practice today: providing healthcare solutions for the future sets out how GP leaders believe the profession will have to adapt.
The GPC calls for practices to collaborate to extend hours, as well as more use of telephone and internet consultations to extend access.
It calls for GP training to be extended to five years, and sets out proposals to improve urgent and out-of-hours care. The GPC report calls for integration of all unscheduled care, including GP out-of-hours, NHS 111 and hospital emergency departments.
Urgent care services should be removed from the competitive tendering process to enable commissioners to select services based on patient safety and resource efficiency, the report argues.
Practices, the document suggests, should be more closely involved in monitoring quality of out-of-hours providers, and calls for a minimum clinical staff/population ratio.
Other key proposals include:
- General practice needs a more integrated and personalised model of patient care that is delivered by a team built around the GP practice. This would involve working more collaboratively with diagnostic, specialist care, community health and social care teams.
- Improving urgent and out-of-hours primary care services. This could include a clinician-led first point of contact, telephone triage service and reforms to the tendering process for out-of-hours care, such as NHS 111.
- Improved accessibility and local accountability by looking at innovative ways of working such as practices collaborating to provide extended surgery opening times across a community or using the latest technologies, such as Skype, as an alternative to face-to-face consultations.
- Empowering patients as partners through measures such as strengthening the patient voice in local CCGs and through the further development of practice-based patient participation groups.
GPC chairman Dr Chaand Nagpaul said: ‘Our vision for general practice is a bold plan to address both the immediate pressures facing GPs and develop a long-term strategy for patient care by improving co-ordination, integration and quality.
‘We need to look at new ways of working that can help GPs play a central role in delivering care that is more efficient and responsive to the needs of patients who increasingly need services that are more personalised and closer to home.
‘To make these ideas a reality general practice needs greater investment to enable an expansion of the GP workforce and to fund new and innovative ways of working. We must end the uncertainty about future funding which is holding back GPs from meeting short-term challenges and setting long-term goals that could be a solution to alleviate some of the pressure on the NHS as a whole.
‘Our plan comes at a crucial time for general practice which is under strain from spiralling levels of patient demand and falling resources. The BMA’s new research highlights that many GPs are facing burnout and feel that current pressures, especially the uncertainty over future funding, are making it difficult for practices to undertake long term strategic planning. These are barriers that we must overcome.
‘The BMA is keen to hear the views of grassroots GPs about the future of general practice and I would encourage every GP to share their views with us so we can continue to develop our proposals for the future.’