General practice will not remain “the jewel in the crown of
the National Health Service”, as it is often described, without
change. Indeed, given the onslaught of criticism directed at
this health sector by the media in recent times, it might appear that it has already
lost much of its sparkle and will soon be neither fit for
purpose nor sustainable.
The need for change was set out by NHS England in its March 2014 report, Improving General Practice - A Call to Action ( NHS 2 014). T he d rivers w ere identified as an ageing population, growing co-morbidities and increasing patient expectations, resulting in a large increase in consultations; increasing pressure on NHS financial resources, which will intensify further from 2015/16; growing dissatisfaction with access to services; and persistent inequalities in access and quality of primary care.
The argument for providing more personalised, accessible community-based services for patients to help improve community health and reduce avoidable pressures on hospital resources has been persuasively made, and the challenges faced in making this vision a reality widely acknowledged. It is currently high on the political agenda. But one of the many questions that remains unanswered is this: how engaged and supported are the workforce who will help deliver the new agenda?
The GP recruitment crisis has hit the headlines with increasing regularity over the past two years. In phase 1 of Call to Action, NHS England pointed out that while the numbers of full-time equivalent GPs had increased over the past ten years, the GP workforce had grown at only half the rate as other medical specialties and had not kept up with population growth.