Most GPs not convinced partnership model can be revitalised

More than half of GPs are not convinced that the partnership model of general practice can be revitalised, a survey by GPonline reveals.

GP consultation (Photo: iStock.com/sturti)
GP consultation (Photo: iStock.com/sturti)

Just 48% of 459 GPs who responded to a GPonline opinion survey said they believed the model could be revitalised, while 18% said it could not and 34% were unsure.

Among 146 existing GP partners who took part in the survey, just 54% said the partnership model could be revitalised - with 17% saying it could not and 29% unsure.

Responding to the findings, Dr Nigel Watson - the New Forest GP leading an independent review commissioned by the government on GP partnerships - said the GPonline survey demonstrated the scale of the challenge facing his review.

GP partnerships

But he said the finding that only 18% of GPs believed partnerships could not be revitalised reinforced his view that the model could be saved.

Findings from the latest GPonline poll follow official statistics published last month by NHS Digital that showed general practice is losing 100 partners a month. A poll earlier this year by this website found that only one in five GPs now see partnerships as the most attractive career option in general practice.

The total number of GP partners in England fell from 24,826 in September 2015 to 22,285 in June 2018 - a drop of 10%.

Dr Watson is set to publish interim findings from his review at the start of October. A set of 23 key lines of inquiry published earlier this year identify workforce, workload, the business model of general practice and the role of general practice in the local healthcare system as priority themes.

Review proposals

Dr Watson - who is also chief executive of Wessex LMCs - told GPonline it was clear what would happen 'if we do nothing'.

But he said meetings and discussions across England as part of the review process had been positive.

'We have met lots of people, and much of what we are talking about around key lines of enquiry, to do with workload, workforce, the balance between risk and reward in partnerships, the idea of having more of a say in the system - that has all met with positive responses, and I think we can build it into positive proposals.

'We have to articulate something people are prepared to support, but also invest in.'

Dr Watson added that he believed that general practice had 'an opportunity here that won't come around again'. I think politicians and the NHS chief executive recognise that not only is general practice in a difficult place, but that something has to be done to support and help it.

Practical solutions

'The difficulty is the lack of clarity on what that means - and that is why this review has to come up with practical solutions.'

Responses from GPs taking part in the survey reveal the wide gap in views that exist within the profession about partnerships.

Some respondents called for all GPs to become partners, while others called for a move to a pay structure in line with hospital consultants.

One GP said: 'The partnership model should be revised and made attractive again - salaried posts should all be changed to partnerships unless a doctor chooses not to be a partner for personal reasons.'

Another said: 'Partnerships are the bedrock of general practice. They allow long-term commitment and continuity of care and a gatekeeper role. Unfortunately none of this can easily be converted into a monetary value for the government.'

One respondent said: 'They are at risk and will be done away with, so we should embrace that and ask for similar pay and conditions as hospital consultants and be redesignated 'community physicians' or 'family medicine physicians'.

The partnership review has been backed by both the RCGP and the GPC. Responding to the launch of the review earlier this year, GPC chair Dr Richard Vautrey said: 'We know that our independent contractor status and GP partnership model are good for doctors, our staff, patients, communities and the wider NHS, but we also know that many practice partnerships are struggling to recruit new GPs as doctors raise increasing concerns about rising workload pressures, premises liabilities and indemnity risks.'

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