Transforming primary care

Abstract

Last week saw two important publications on primary care in the UK. The General Practice Forward View, published by NHS England and developed in partnership with the Royal College of General Practitioners and Health Education England, sets out a plan to transform general practice over the next 5 years. Backed by an extra £2·4 billion a year, the plan outlines steps to increase the number of general practitioners (GPs) and co-workers, as well as measures to reduce workload stresses, develop infrastructure, and support care redesign to enable increased access to GPs.The second report, Primary Care, by the House of Commons Health Committee, emphasises the need for increased funding of general practice to improve access to care and services for patients, such as extending the traditional 10 minute appointment time.Both reports acknowledge the unprecedented strain on today's GPs, with rising demand from more patients, many of whom have increasingly long-term complex medical conditions. Getting an appointment with a GP is becoming ever more difficult for patients in many areas, while GPs themselves are retiring early, moving abroad, or unable to recruit to fill vacancies.Primary care is the backbone of the NHS. 90% of all NHS patient contacts take place within primary care. Moreover, as Florian Stigler and co-authors outline in Correspondence this week, primary care builds an effective health-care system through its core principles of first contact, continuous, comprehensive, and coordinated care. For countries aspiring to universal health coverage, a strong primary care system is an essential underlying framework. For the NHS, urgent repair, support, and investment into primary care is needed to rebuild and strengthen its backbone. Recruitment from countries with weaker health systems than the NHS is not the answer; training more doctors in the UK, encouraging a career in general practice, improving retention, and increasing task sharing with co-workers (such as pharmacists) are far better solutions. Transforming general practice into a career that is once more desirable and rewarding is essential for the NHS to survive. Last week saw two important publications on primary care in the UK. The General Practice Forward View, published by NHS England and developed in partnership with the Royal College of General Practitioners and Health Education England, sets out a plan to transform general practice over the next 5 years. Backed by an extra £2·4 billion a year, the plan outlines steps to increase the number of general practitioners (GPs) and co-workers, as well as measures to reduce workload stresses, develop infrastructure, and support care redesign to enable increased access to GPs. The second report, Primary Care, by the House of Commons Health Committee, emphasises the need for increased funding of general practice to improve access to care and services for patients, such as extending the traditional 10 minute appointment time. Both reports acknowledge the unprecedented strain on today's GPs, with rising demand from more patients, many of whom have increasingly long-term complex medical conditions. Getting an appointment with a GP is becoming ever more difficult for patients in many areas, while GPs themselves are retiring early, moving abroad, or unable to recruit to fill vacancies. Primary care is the backbone of the NHS. 90% of all NHS patient contacts take place within primary care. Moreover, as Florian Stigler and co-authors outline in Correspondence this week, primary care builds an effective health-care system through its core principles of first contact, continuous, comprehensive, and coordinated care. For countries aspiring to universal health coverage, a strong primary care system is an essential underlying framework. For the NHS, urgent repair, support, and investment into primary care is needed to rebuild and strengthen its backbone. Recruitment from countries with weaker health systems than the NHS is not the answer; training more doctors in the UK, encouraging a career in general practice, improving retention, and increasing task sharing with co-workers (such as pharmacists) are far better solutions. Transforming general practice into a career that is once more desirable and rewarding is essential for the NHS to survive. No universal health coverage without primary health careUniversal health coverage is currently the aspiration of many countries worldwide. We commend Michael Reich and colleagues1 for analysing lessons learned from different country experiences, but we believe there is a crucial element neglected within the ongoing universal health coverage debate. Full-Text PDF