Written evidence submitted by Jubilee Field Surgery (FGP0245)

Is the traditional partnership model in general practice sustainable given recruitment challenges, the prioritisation of integrated care and the shift towards salaried GP posts?

The traditional partnership models provides stability of provision, continuity of care and enables clinicians to feel fully invested in the community they serve.

It is impossible to measure the benefit to patients that this brings, but it is undoubtedly enormous.

Over the recent pandemic, GP Partners have gone above and beyond the call of duty time and again, often taking a lead in vaccination clinics and filling service gaps whenever they appeared.

Our own GP Partner has attended every single vaccination clinic we have run, weekend after weekend.

At present there are not enough incentives for GPs to become partners, so the salaried roles are more attractive - why take on additional responsibility if there is no added benefit?

Even so, salaried roles are hard to fill, so neither salaried nor partnership roles are being filled.

GP partners play an important role in managing and investing in the premises that GP surgeries operate from.

Who will take this on if not GP partners? NHS Estates cannot manage the current estate, so would be completely unable to take on the Primary Care estate challenge.

Has the development of Primary Care Networks improved the delivery of proactive, personalised, coordinated and integrated care and reduced the administrative burden on GPs?

No absolutely not.

PCNs take GPs away from direct patient care to attend endless meetings as Clinical Directors or Board members, or to supervise other roles employed by the PCN such as Clinical Pharmacists or Physician Associates.

Trying to align different practice cultures within a PCN can be stressful and time consuming.

Practice Managers - already under strain and difficult to find - are now spending time being PCN managers, again taking them away from their primary role in a GP surgery.

The administrative burden on GPs is increased in a PCN - more targets to chase, more audits to run, more meetings to attend.

To what extent has general practice been able to work in effective partnerships with other professions within primary care and beyond to free more GP time for patient care?

We have not seen any evidence of effective partnerships with other professions in Primary Care.

What role does having a named GP—and being able to see that GP—play in providing patients with the continuity of care they need?

Having a named GP means nothing if you can’t see that GP, and are directed to a Physio, Pharmacist or Physician Associate.

Making working conditions better for GPs and rewarding Partners adequately would mean a patient could see their named GP/GP of choice as a first contact, often preventing the need for multiple appointments with a variety of professionals before they eventually get to consult with a GP.

Proper funding would enable 15 minute appointments as standard which would improve quality of care hugely (something we do in our practice).

•               What are the main challenges facing general practice in the next 5 years?

Retiring Partners over 50 will leave the profession en masse and leave a gaping hole.

What can be done to reduce bureaucracy and burnout, and improve morale, in general practice?

Re-think the CQC model of regulation. This is a massive demoralising factor because it feels confrontational and lacking in understanding about the realities of front line medical practice.

Return to something like the PMS model of contract, with fewer small ‘pots’ of money that require effort and tie to measure and report on.

Stop briefing against General Practice in Government please, this is the most demoralising thing of all.

To what extent does the Government and NHS England’s plan for improving access for patients and supporting general practice address these barriers?

The plan has completely shattered the profession because it shows so little understanding of the realities of pandemic practice.

GPs are independent professionals with a high degree of integrity and genuine care for their patients.

Trust them to know what is the best care for their patients and how best to provide it locally - it’s what they are trained for and what gives them pride and job satisfaction: if they think a face to face appointment is necessary, they will provide it; it they think patients are safer having a telephone consultation instead, then this will be for a very good reason.

Stop micro managing from the top down and be guided by the professionals.

Dec 2021