Interview: GPs starting to feel valued by NHS, says GP Forward View leader

GPs are 'increasingly positive' about support for general practice from health service leaders but want support to come faster, NHS England's director of primary care has said.

NHS England primary care director Dr Arvind Madan (Photo: Pete Hill)
NHS England primary care director Dr Arvind Madan (Photo: Pete Hill)

Dr Arvind Madan told GPonline the profession was ‘starting to believe’ that NHS England is backing their service almost a year on from the launch of the GP Forward View in April 2016.

The London GP, who has led the wide-ranging package of support launched in response to demands from GP leaders and LMCs to avert a crisis in general practice, said the ‘narrative’ had changed since NHS officials began implementing the rescue plan.

‘If we look back to a year ago there were pictures in the media of [GPs] holding green cards voting for undated resignations at the LMCs conference,' Dr Madan told GPonline. ‘I'd say we have moved a long way.’

GP morale

A year ago GPs felt unvalued, the Hurley Group partner said, then they began to recognise NHS England had a plan - but did not quite believe it - and now they just want the plan implemented faster.

‘We have moved from a position where we felt undervalued, to actually we feel that people get we are a big part of the solution,’ he added.

Dr Madan accepted NHS England had been too slow to deliver some of the funding promised under the GP Forward View resilience fund. He has previously admitted funding for the predecessor vulnerable practices fund had been spent too slowly.

Last week the BMA demanded urgent action after it said practices in some areas had yet to see funding promised as part of the £40m, three-year resilience fund.

Dr Madan said that £11.9m of the £16m 2016/17 tranche had been delivered by the end of February, with 589 practices so far receiving direct support and others benefiting through localities or across groups. That figure clashes with BMA claims that £11 of the £16m fund remains unspent.

GP funding

A further £9.2m of of the £10m vulnerable practices fund had been spent supporting 630 practices by the end of last month. Dr Madan has previously said almost 2,000 practices would benefit from the two funds by the end of 2016/17.

However, Dr Madan told GPonline, LMCs in some areas have asked for the money to be spent slowly to ensure it is effective rather than sped up to meet an ‘artificial deadline’. ‘We have also been criticised for spending it too quickly. So, you can't have it both ways,' he said.

‘If you look back to where we were a year ago and said that by the end of 12 months we will have helped over 1,000 practices directly, people will not have believed it,' he said. ‘But actually that is what has happened. You can have a 95% glass full, or a 5% glass empty story.’

Dr Madan accepted the procurement requirement to develop 'provider markets' of support for practices meant the first year of resilience support would be slower to deliver than subsequent years. ‘Those markets take time to bring to life,' he said. ‘Particularly if they have not been given clarity prior to that on the fact we are going to be backing this kind of activity. So, I expect future years to be better.’

GP transformation

Dr Madan said he was ‘really proud’ of the work done by NHS England’s GP Forward View team. ‘They are really passionate people, working all the hours to do what they can because they feel passionately about general practice, too. So, I think, we are doing stuff no one else has done before.’

He added: ‘The GP Forward View is 82 moving parts over five years, culminating in £2.4bn extra a year. This is a massive step change [and a] vote of confidence in general practice, and I have been really pleased to see how much progress has been made in not even 12 months yet, and how the whole machinery within NHS England and all the arm's length bodies has geared up to supporting general practice to become not only more stable but to transform into another version of itself that gets ahead of patient demand.

‘So, actually, I think as time passes, the momentum of the system behind general practice is increasing, and I think the degree of hope for where general practice is going is increasing, particularly from the low point from which we started a year ago, so I have no reason we won't accelerate.’

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