Dr Gerada, the chairwoman of NHS England’s primary care clinical board for London, made the call for increased funding at a Westminster Policy Forum event in the capital on Tuesday.
Dr Gerada warned that practices should also consider co-locating with hospital specialists, libraries and education services to tackle the premises crisis. She highlighted improvements to premises, the way GPs use data and how GPs work in teams as key factors that could transform primary care in London.
An October report by former health minister Lord Darzi found that a 'staggering three quarters' of London premises were in need of rebuild or repair. He called for a £1bn investment to help drive improvements.
Dr Gerada – who confessed she currently consults in a ‘converted cupboard’ – said it was time to ‘look sensibly where we can use existing premises’ to help rectify the problems.
She added: ‘We now need a new discussion with commissioners, councillors and patients as to how we start to properly use this space that we have, how we plan care for an entire population and maybe in essence start to look at whether we should be rationalising – and I'm not talking about Darzi centres – but I think there is sense in co-locating premises with diagnostics, with specialists, with libraries and education.’
Funding and integration
The road to improvement will be a ‘long, hard slog’ and require added investment, she said.
‘We cannot transform my profession without more resource. For London, and that's all I can speak for at the moment, we need to have a 1% minimum increase in investment per annum for about five years,’ she said.
‘To put that in context, we’re seeing about a 6% increase in the amount spent on specialist services at the moment. So you can see that to transform the profession, to transform the NHS to make it sustainable, a 1% increase is not something that is insurmountable.’
But increased funding alone could not solve all of general practice’s problems. Large divides between primary and secondary care, healthcare and social care are just some of the ‘barriers’ to transforming primary care, she added.
‘We've got to change, because it’s not enough just to have the resource and money put into the profession. What we now need to do is start changing the culture that we all work in within the NHS. Because if we don't, then no amount of fairy dust or money is going to stop what we’re seeing: the exodus of good staff leaving the profession.’
