Strengthening general practice in deprived localities

Abstract

The White Paper Equity and Excellence: Liberating the NHS 1 has placed clinicians firmly in the driving seat to determine the nature and quality of care for our patients. The role proposed for general practice has been enhanced so that we will take increasing responsibility for commissioning appropriate services, and work with local authorities to improve the quality of health through more personalised care with emphasis on prevention. Future commissioning of secondary care could take place through general practice consortia working together and working with their local provider trusts. However, these changes are proposed at a time of unprecedented financial constraints, both within the NHS and globally. These financial pressures and the imperative to deliver care as close to the patient as possible will lead to more care moving into the community. One of the current pressure points is the increased attendance at emergency departments; another is managing patients with long-term conditions and comorbidities.1 The review of the Working Time Directive's impact on training healthcare professionals, Time for Training ,2 has made some important recommendations for the future delivery of care, so that doctors and other healthcare professionals in training are able to develop the skills and behaviours necessary to deliver future health care. It recommends more consultant presence throughout the 24-hour period, particularly for the acute specialties, and greater use of the multiprofessional team. The changes …