General practice at the core of neighbourhoods

Abstract

There is a current emphasis on transformation in the NHS being driven as close to the patient as possible, namely by focusing on neighbourhoods. General practice represents the largest number of patient contacts at a neighbourhood level and is also the most recognised form of contact with the NHS by the public. It is critical to success that the organisation of general practice supports neighbourhood working and integrated neighbourhood teams (INT). GPs are experiencing widespread burnout and low morale. Increasingly GPs are choosing part-time work and portfolio careers. There has also been an erosion of GP identity and divisions are emerging within the profession between salaried and partner GPs. Despite a strong commitment to continuity of care, the system is failing to provide it. Primary care handles 90% of patient contacts with less than 10% of the national budget—a stark indication of its efficiency, but also its vulnerability. The number of GPs leaving the profession exceeds those joining, and existing GP’s workload is greater than ever. A recent Royal College of General Practitioners survey suggested that 42% of GPs are unlikely to be working …