NHS reforms must help overworked GPs improve preventive care

The NHS must do more to allow overstretched GPs to improve preventive care, NHS England's clinical director for cardiovascular disease prevention has said.

Speaking on the need for GPs to ‘get serious about prevention’ at the RCGP annual conference in Harrogate, Dr Matt Kearney emphasised that GPs need to find ways to work differently in order to work more effectively.

It is clear that GPs have ‘no capacity to do more’ than they currently are now, Dr Kearney said. However, he said that GPs can make three major changes to help tackle the main behavioural and clinical factors driving morbidity and mortality rates.

The first is population-level interventions, where STPs will offer opportunities for GPs to take a leadership role in planning wider care outside of general practice, Dr Kearney said.

The second is to support behavioural change in individual patients. Over 1m GP consultations take place a day, offering plenty of opportunities for GPs to ‘advise on lifestyle risk factors’.

The third is clinical preventions, where there is ‘opportunity for improvement’, Dr Kearney said. High BP contributes to half of all strokes and heart attacks, AF is associated with a five-fold increased risk of strokes and high cholesterol is linked to a progressive increase in risk of stroke and heart attack.

Treating these factors can drastically reduce these risks, but is not widespread. Currently, only 60% of patients with hypertension are being treated to the ideal level, just one in three AF patients are being given anticoagulants and one in two with high cholesterol are treated with statins, Dr Kearney said.

‘Clearly a lot of improvements can be made by improving this,’ he said. ‘If everybody eligible for anticoagulants got them, 10,000 strokes could be saved a year.’

Prevention can reduce demand

But he went on to add: ‘That’s all very well, but need to think in real world. We’re very overworked and don't have capacity to do this - it is trumped by other priorities.

‘So I don't think we're going to improve care by working harder - it can only be done by making the system work better for us and patients.

‘There’s a real opportunity for us in prevention to reduce demand and improve care. I think our starting point has to be recognise this is an existential threat.

‘Second of all we have to acknowledge our capacity to do more. We should grab the opportunity that comes from the Five Year Forward View.

‘It is worth us working as a priority to get better at secondary prevention - we can stop a lot of heart attacks and strokes in a relatively short time.’

He added: ’We should consciously rise to prevention challenge. We should challenge ourselves as GPs and nurses to lead the conversation about prevention in the NHS and ensure the solutions reflect the world in general practice.

‘We need to challenge the primary care system to find more ways of treating these high risk conditions, because it will reduce disability, mortality - and it will help reduce our burden.’

Full coverage from the RCGP annual conference

Photo: Pete Hill

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

GMC sign

Overseas-graduate GPs fare worse in medical tribunals due to lack of legal help

UK GPs who graduated overseas face worse outcomes in GMC cases because they are far...

Woman using HRT patch

Practical advice for GPs on prescribing HRT

GP menopause specialists Dr Louise Newson and Dr Olivia Jones provides an overview...

Vaccination tracker

UK COVID-19 vaccination programme tracker

GPs across the UK have led the largest-ever NHS vaccination programme in response...

NHS logo on tiled wall

PCNs falling short on 26,000 staff target and need more flexibility, GPs warn

Government plans to bring in 26,000 staff by 2024 to support general practice are...

Talking General Practice logo with picture of Dr Ed Cantelo and Dr Tommy Perkins

Podcast: How two GPs set up a business to advise doctors about finance

Talking General Practice speaks to GPs Dr Tommy Perkins and Dr Ed Cantelo from Medics...

Houses of Parliament

MPs from all parties call on government to do more on GP shortage

MPs from all parties have warned the government that it needs to do more to tackle...