The future of primary care? Reflections on the Primary Care Workforce Commission report.

Abstract

There is a general consensus that there is a crisis in general practice in the UK with a ‘perfect storm’ of workload pressures, inadequate funding, and low morale. Responding to a catastrophic fall in recruitment and poor retention of experienced GPs, a national 10-point ‘general practice workforce action plan’ has been laid out by NHS England (NHSE).1 Health Education England commissioned Professor Martin Roland to chair a Primary Care Workforce Commission to gather evidence and make recommendations not only to address the current crisis, but also to project forward and attempt to ‘future proof’ the profession. Proposed changes are intended to support the development of ‘a modern primary healthcare system’ in the context of ‘challenging and fulfilling careers for health professionals’, and maintaining pride in the ‘standard of care’ delivered to patients.2 Professor Roland has the right credentials for the job, having maintained a clinical workload as a GP alongside his distinguished academic career. Furthermore, during his leadership, the National Primary Care Research and Development Centre undertook a portfolio of studies addressing primary care workforce issues, including skill mix in primary care, equity in the geographical distribution of GPs, and GP satisfaction and work stress.3–6 In this Commission, his team of equally experienced colleagues, academic GPs, and external experts took evidence from a wide range of bodies, including individual GP practices, clinical commissioning groups (CCGs), national bodies such as the Family Doctor Association and the Royal College of Nursing, and charities such as National Voices, and made site visits to observe innovative practices and organisations. The focus of these recommendations is on ‘primary care’ rather than general practice, but, while the report rejects uniformity in favour of locally appropriate variations, it identifies GP practices as vital units in the coordination and delivery of safe and …