GP partnership review
The final report of the GP partnership review, led by Dr Nigel Watson, was published on 15 January 2019. The report follows Secretary for Health and Social Care, Mr Matt Hancock, announcement in February 2018 that a review should take place into the partnership model. The Department of Social Care, NHS England, the General Practitioners Committee of the British Medical Association (GPC) and the Royal College of General Practitioners (RCGP) agreed the terms of reference.
The final review received written feedback from over 120 individuals and organisations, visited 25 practices around the country and held over 40 meetings in order to make recommendations on the challenges currently facing partnerships and how best to reinvigorate the model.
Pros and cons of the current partnership model
The report identified the following pros and cons.
- Freedom to innovate/be flexible due to being a small/medium business
- Relative autonomy in decisions
- Creating the desire to succeed as business owners
- Cost-effective delivery model
- Long-term and deep understanding of a local population’s needs and continuity of care across generations
- Workload: Increase in demand for services due to changing population demographics
- Workforce: Issues regarding recruitment and retention and the number of GP Partners declining
- Financial risk: Largely with premises ownership, medical indemnity, staff costs and the personal financial risk of being in an unlimited liability partnership
- GPs feeling demoralised and unvalued as a profession
The report sets out detailed recommendations which include reducing the personal risk and unlimited liability in partnerships, increasing the number of GPs who work in practices and in supporting roles, increasing capacity and range of professionals to support patients in the community, and medical training increased in general practice.
Some have noted the flaws in the recommendations set out. Chris Kenny, Chief Executive of the MDDUS, has noted that, should the state backed indemnity scheme be implemented, GPs in England and Wales would still need indemnity to cover complaints, Coronial proceedings, GMC hearings and non-NHS work.
King’s Fund Senior Fellow, Beccy Baird, commented that ‘unless the NHS can deliver a credible national strategy to fill gaps in workforce they may count for little.’ Ms Baird further stated that ‘general practice will need significant support and training in relationship building, management and organisational development if it is to really achieve the ambitions set out for it.’
It is clear that many think that ‘there is no miracle cure or panacea within this report… recommendations will take time to implement and decisive action.’ However, commitment to the reform of GP practice can be seen in the NHS Long Term Plan, published by NHS England on 7 January 2019, which noted an increase in investment in primary medical and community health services over the next 5 years, which is said to help fund demand related pressures, workforce expansion and new services.
NHS England has previously committed to an extra £2.4 billion a year to support general practice by 2020/21 as per its General Practice Forward View. Professor Stokes-Lampard, Chair of the RCGP, described the review as ‘a vote of confidence in GP partnerships.’
However, it is clear that many eagerly await the Secretary of State’s response to the review and confirmation as what elements will be implemented.
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