Around 20% of the 1,500-plus practices in London are single-handed, a figure well above the national average of around 14%. But a report by NHS London warns: ‘Improving access and meeting public expectations is difficult unless this model of delivery is changed.’
Launching the London region 'Call to Action' consultation on the future of health services in the capital, NHS officials said general practice would have to scale up to meet future demands.
The consultation document sets out the case for 'urgent and radical' change across the NHS in London. CCGs, alongside health and wellbeing boards, will run local public engagement events and incorporate the conclusions into their five-year strategic plans.
NHS leaders said the challenge of a growing, ageing population, higher patient expectations, and zero financial growth will create an ‘unprecedented’ £4bn funding gap by 2020, and called for radical change in service delivery to cope.
The document said patients want better access to GPs and those with long-term conditions would like more frequent contact.
NHS England’s London regional director, Anne Rainsberry, said clear standards would be developed setting out how primary care service should be delivered in future, in the same way as standards have been developed for secondary care over the past few years.
‘The way in which standards are delivered will vary,' she said, and there would be no prescribed model.
Features of new models could include scaling up general practice, working in networks and federations, integration with secondary care, greater range of services, and greater access.
London regional medical director of NHS England, Dr Andy Mitchell, said there was ‘broad agreement’ among GPs that a ‘networked’ model was necessary.
‘The move towards a federated model whereby there is much more cooperation and collaboration with groups of general practitioners, that would allow them to offer a much wider range of services, and much wider range of expertise, and it would provide that focus as well for hospital specialists to move and practice in the community, because they know that the messages can be transmitted more easily.’
‘It’s a question of the incentives,' he added. ‘It’s the how. That’s the real challenge we face; what are the incentives that are going to encourage GPs to move that way? And what are the incentives for quality standards?’
The consultation is the London regional version of the national call to action launched by NHS England chief executive Sir David Nicholson in July. The call to action on primary care is being run by NHS England’s deputy medical director, GP Dr Mike Bewick, and closes next month, when NHS England's London division will launch its primary care vision.