Who will write the obituary for UK General Practice? Will you know the doctor looking after you when you die?

I was reflecting on the 3 years since I retired. In my own region there are numerous practices who cannot recruit new doctors. There are practice teams falling apart, and there are nearly 10% of practices under “special measures” which means they need to be managed by the local Trust and manned by expensive locums. The undercapacity issue is now driving those who started with altruism into systems where there is a disincentive to make a claim, and where performance management is less intrusive. I hope there is someone willing to write the obituary for UK General Practice..

General Practitioner partners much younger than myself are emigrating, retiring, or simply moving to locum work, without long term commitment. Some of the best and most experienced have gone, and more will follow..

Francis Elliott in the Times on 29th July 2014 reports: Right to die at home register ‘would save cash’ and five years ago Britain was ranked first on Quality of Death

On 26th June Public Health England released a report and commented: End of life care improving according to report. The ‘What We Know Now 2014’ report suggests a growing understanding within the health sector of what is important to people at the end of life. The percentage of people dying at home increased from 35% to 44%, and the report says:

“The factors most important to people at the end of their life are having pain and other symptoms managed effectively, being surrounded by loved ones and being treated with dignity. ” (Continuity of care must come closely after these). 28% of people would choose a Hospice, if it is available, and often to protect their relatives. Continuous GP care is needed more in rural locations without easy access to Hospice or with Hospice at Home.

The Times 26th June 2015 (absent from website) reports “More patients are allowed to die at home” and the headline reveals the gradual loss of autonomy for most of us as we approach death. Advanced directives can help, but there is nothing to replace open discussion between family and regular GP. Why should I need permission to die at home?

The scandal of ‘appalling’ end-of-life care

Palliative and Terminal Care should be fully funded.

Quality of death – is not talked about – General Practice is “Closing Down” …

End-of-life care for terminally ill ‘needs major overhaul’

The NHS and ‘cradle to the grave’



This entry was posted in A Personal View, Commissioning, General Practitioners, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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