Viewpoint - Multimorbidity and its challenge to general practice

In his latest editorial, RCGP Scotland chairman Dr John Gilles reflects on multimorbidity and a challenge to the way primary care is delivered.

Dr Gillies: 'Need to move on with our case for extended and enhanced GP training'
Dr Gillies: 'Need to move on with our case for extended and enhanced GP training'

The big news this month is the publication of a landmark paper on multimorbidity, deprivation and mental health from the Universities of Dundee and Glasgow coordinated by the Scottish School of Primary Care, and funded by the Chief Scientist Office. It was launched by Richard Horton, editor of The Lancet at a press conference at RCGP in London on 9 May.

This groundbreaking research challenges the basis upon which we currently plan and deliver primary care in Scotland, and indeed in the UK. The findings will come as little surprise to many GPs - people with one disease having multimorbidity is more common in deprived populations and mental health problems increase with increasing multimorbidity - but they demonstrate the vital importance of carrying out research that gives the reality of general practice legitimacy in the worlds of research and policy. Congratulations to Karen Barnett, Stewart Mercer, Mike Norbury, Graham Watt, Sally Wyke and Bruce Guthrie. 

We will need time to digest the consequences of this. Reading the findings made it clear to me the need to move on with our case for extended and enhanced GP training, which will result in GPs with enhanced clinical, generalist and leadership skills.

I was honoured to deliver the KM Seedat lecture on 11 May to the conference of the South African Academy of Family Physicians on ideas and lessons from RCGP on improving quality in primary care. They are establishing a national health insurance scheme. As Nigel Crisp suggests in ‘Turning the World Upside Down’, this is an opportunity for joint learning or co-development. Perhaps they can learn from our mistakes as well as our successes.

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