Dr Varnam said that most STP areas were looking at what extra money general practice would need in order to provide more services.
‘Everyone has realised that general practice could contribute more and that general practice is more cost effective. So everyone is working up their plans, not to move care without funding, but to say: "OK, if GPs could do this better how much would it cost and how could we move the money with patients",’ Dr Varnam said.
There has been concern from LMCs in some areas that STPs are planning to transfer huge amounts of work into general practice without proper funding and support. Other STPs, including those in east London and Somerset, are preparing for a significant drop in GP numbers due to the current workforce crisis.
Last month primary care academics warned that urgent investment in general practices was needed to reverse the damage done by years of underinvestment if STPs were to succeed.
Primary care funding
However, Dr Varnam said that STPs had recognised that money needed to move into primary care if practices were being asked to do more work, although he admitted it would be difficult for many practices to take on additional work in the current climate.
‘Most practices aren’t ready to do new work yet, they need to work through the current challenges. But what’s been really encouraging for me to see is that all of the STP thinking has recognised what a gem we have in general practice and that we don’t have to put up with so many people being in hospital unnecessarily if we moved the money,’ he said.
‘Some plans are still relatively high level, but I’ve not yet encountered a place where people aren’t getting to real detail to ask what bits of care, for which patients would be better to have in primary care, how much would it cost and what sort of workforce growth practices need.
‘In some places people are even saying, if it’s going to take a few years to grow new people for the primary care workforce is there anything we can do in the interim to share workforce. If it would be better happening in a primary care-led way and we have some therapy or nursing staff, could we move these people into general practice.’
Earlier this week the BMA called for STPs to be abandoned at its annual representative meeting, saying that they were ‘vehicles to try to legitimise further cuts to vital NHS services’.