Collaboration for Academic Primary Care (APEx) Blog
Collaboration for Academic Primary Care (APEx) Blog
Posted by jchoules
3 July 2018What the NHS means to me
As a GP in the NHS, I feel proud to be part of one of the largest and most impressive work forces in the world, particularly when its aim is to provide good quality healthcare for all patients in the UK, regardless of their wealth. I am also a user of this service that covers everything; from routine health screening, to antenatal checks, emergency healthcare, management of long-term conditions and end-of-life care. As one of over a million patients accessing NHS care in a 36 hour period, I felt safe and provided for; as a new mother on a hospital ward, and later at home with my community midwife.
In addition, I contribute to primary care research and to education within the NHS. Along with over 200 academic GPs in the UK, I aim to provide guidance, through research and evidence, for the future development and organisation of the UK health service. I teach, and I promote lifelong learning, to ensure a competent and confident workforce; from the medical student, to the junior doctor, to the fully-fledged GP.
What is the role of primary care within the NHS?
Primary care is known as the “front door” of the NHS as it is the first point of contact for most NHS patients. It is delivered by GPs, dentists, pharmacists, optometrists, NHS walk-in centres and the NHS 111 phone service. A whopping three hundred million consultations take place in General Practice each year. Whilst patients are generally satisfied with the care that they receive, it is often difficult to access a GP. The “front door” is not always as open as we would like.
What has changed in primary care in my career?
I qualified as a doctor in 2007 and completed my GP training in 2013. Over the last ten years I have witnessed significant restructuring of the NHS and ongoing reform of primary care services. Of note to me as a newly qualified GP, clinical commissioning groups replaced primary care trusts, with the aim of enabling clinicians to lead on the planning and commissioning of healthcare services for their local area. Many GP practices are merging with the aim of sharing knowledge and resources. However, funding for hospital services has been increasing at twice the rate of funding for general practice services and we are seeing more and more privatisation of health services. NHS staff have become demoralised; junior doctors are leaving to work abroad, senior doctors are taking early retirement and we are currently in the midst of a GP workforce crisis.
What needs to change in the future?
As the population grows, so too will the number of older patients with multiple health problems and these patients are known to consult frequently. This will put incredible strain on the NHS and we will need to be financially ready to cope with it. Patients and their carers should be involved in making decisions about their healthcare and the services that are commissioned. Healthcare needs to be patient-centred and individualised. We need to seek ways to enable continuity of care with the same healthcare practitioner and longer consultations for our most vulnerable patients.
In order to increase positivity amongst the GP workforce the workload needs to be made more manageable. However, consideration should be given to the wellbeing of GPs, and that of other healthcare practitioners, when restructuring and delivering new health services for patients.
We need to encourage more medical students, along with nursing, pharmacy, physiotherapy and occupational therapy students, into careers in primary care. We need to use their skill-sets flexibly, and in a close-knit multidisciplinary unit, to provide high quality but cost-effective healthcare. We should give undergraduates the skills to manage the uncertainties that they will inevitably face once qualified, and encourage them to become health service pioneers and leaders. We should invite them to problem-solve, look beyond guidelines and question evidence, to work cohesively with their colleagues in secondary care, and to embrace the challenge that is the future of the NHS.
The NHS at 80?
Let’s make sure it’s still here!