General practice is making a leap in the dark – New models of working risk throwing the baby out with the bathwater

General Practice risks being consumed by patient expectations and the advances of technology. Family base continuous holistic care in the “old model” seems to be disappearing. NHSreality will not be surprised if the public has second thoughts… GPs are voting with their feet, and as patients get more and more disappointments, owing to covert rationing, will private GPs thrive at the expense of increased national inequality? Once there are more “agents” for patients, then more money will be spent. The old fashioned gatekeeper role is the most valued – by ministers in other less efficient countries.

The BMJ Editorial by Martin Marshall, Prof at UCL Medical School, on 28th October opines: General practice is making a leap in the dark – New models of working risk throwing the baby out with the bathwater (2016;355:i5698 )

Read the whole article a-leap-in-the-dark58945-dragonfireattackphoto

A strong case is being made in many countries that the traditional model of general practice needs to change. Critics claim that practices are too small and too isolated, that they are increasingly unable to meet their patients’ needs and expectations, and are unfit to lead the necessary redesign of health systems.1 2 As general practice in the UK in particular struggles with a demoralised workforce and inadequate resources,3 these criticisms are being taken on board. Quietly but rapidly, and in a largely ad hoc fashion, general practice is changing; small practices are closing or merging with other practices, practice networks are forming, the primary care workforce is becoming increasingly multidisciplinary, and new integrated models of care that bring together community and hospital based services are being developed.

Many of these changes may be good for patients and for the health system, but insufficient attention is being paid to the possible unintended consequences…..

Image result for lemmings leap cartoon

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This entry was posted in A Personal View, 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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