Primary care faces 'radical change' in next two years, says Nicholson

Outgoing NHS England chief executive Sir David Nicholson has hit out at media attacks on GPs, but called for 'radical change' to primary care over the next two or three years.

Sir David Nicholson: radical primary care change
Sir David Nicholson: radical primary care change

At the NHS Confederation conference in Liverpool last week, Sir David, who announced his retirement last month in the wake of criticism over his role in the mid-Staffs scandal, said primary care did not offer all patients what they needed. ‘It doesn't deliver for everybody, for people's needs everywhere, and it needs modernising,' he said.

Sir David, who is due to leave his role in March 2014, called for a radical look at how primary care works. ‘I know that many of the CCG leaders want to see a radical change - and indeed many GPs want to see a radical change - in general practice, so let's see how we can make that a reality over the next two or three years.’

He said changes were needed to ‘incentives’ in the system. ‘Everything from the tariff through to the quality premium, through the contract, all of those need to be radically altered to support that case for change and the big conversation.'

Responding to the ongoing row between GPs and health secretary Jeremy Hunt over out-of-hours provision and A&E demand, Sir David mounted a strong defence of GPs. He said he was ‘incensed’ by some of the coverage of the controversy.

‘The potential power and contribution that general practice makes to the health and well-being and healthcare and the running of the NHS is absolutely enormous,' he added. ‘In lots of ways it's the distinctive characteristic of the NHS.'

He praised GPs for taking up leadership roles in the NHS, and said they were doing a ‘fantastic job’. ‘I think we are only at the beginning of understanding the contribution general practice can make for the NHS going forward.’

Earlier at the same conference Mr Hunt denied 'picking a fight' with GPs, saying his fight was with the structures that stop GPs caring for patients.

RCGP chairwoman, Professor Clare Gerada, thanked Sir David for his comments but called for more resources for primary care.

'Hardworking GPs have indeed borne the brunt of unjustified criticism recently and I am heartened by his kind words, as I am sure are many of our members,' she said.

'The RCGP continues to call for more funding and more resources for general practice - including 10,000 more GPs. GPs are the solution to problems in the NHS, not the cause, and this prevailing blame culture highlighted by Sir David needs to stop.

'We do remain concerned that  GPs risk being unfairly blamed for the current pressures in the NHS, when they are doing their utmost to provide the best possible care for patients.'

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