Health May 21, 2019
A bright future for general practice?

By News Feature - Accountable Care Journal

A new report, Fit for the Future: A vision for general practice, outlines the Royal College of General Practitioners' (RCGP) vision for 2030. Among the most prominent 'predictions' made for the future are fifteen-minute minimum consultations to allow GPs to spend more time with patients suffering from complex multi-morbidities, increased continuity of care through the use of 'micro-teams', and an end to isolated working.

The College’s report states that realising the vision is predicated on six ‘enablers’, including that general practice receives at least 11 per cent of the NHS budget in all four nations of the UK; the full-time equivalent GP workforce expands by thousands, as does the wider practice team workforce; and that GP speciality training is extended to at least four years to expose trainees to the full breadth of skills and conditions they are likely to need and see in general practice.

Chair of the RCGP, Helen Stokes-Lampard, emphasises the importance of longer appointments to 'adequately' address the needs of patients and ensure GPs provide "truly holistic care to our patients, considering all the physical, psychological and social factors potentially impacting on their health." However, with falling numbers of GPs in England and workload pressures mounting, she reinforces the crucial need for more resources to support this change.

The study was informed through consultation with more than 3,000 GPs, other health professionals and patients, as well as research commissioned from The King’s Fund.

Key predictions: 

  • An overhaul of the GP-patient record into a personalised ‘data dashboard’, accessible by healthcare professionals across the NHS, and that will draw on data from the patient’s genomic profile and wearable monitoring devices.
  • Networks of GP practices will evolve into ‘wellbeing hubs’ with expanded teams offering a wider range of services, both clinical and non-clinical – and that access will increasingly be via digital and video channels.
  • Continuity of care will be maintained and improved but delivered via ‘micro-teams,' so that alongside having a named GP, patients can build long-term relationships with several members of a multi-disciplinary team. The GP team will include established nursing and pharmacy roles, but also emerging roles, such as physiotherapists, occupational therapists, link workers, dieticians and health coaches.
  • GPs will no longer work in isolation – practices will work in networks or clusters, allowing them to pool resources and people, but facilitating smaller practices to retain their independence and patient lists.
  • A greater use of AI to improve triage systems that assess the severity of a patient’s health needs, enhance diagnosis, flag ‘at risk’ patients, and safely identify the most appropriate care pathway.

Recent research shows that the UK offers some of the shortest GP consultations amongst economically-advanced nations at 9.2 minutes – with another study finding that the average GP consultation involved discussion of two and a half health problems. It is estimated that the number of people with a single chronic condition increased by 4 per cent, and with multiple chronic conditions by 8 per cent per year between 2003/4-2015/16 – and that patients with long-term conditions account for around 50 per cent of all GP appointments.

Professor Stokes-Lampard is confident in the work that is already being done to drive general practice towards the goals outlined in the vision. However, she notes the importance of ensuring "whatever we do is safe, evidence-based and ultimately works to make general practice and the wider NHS more sustainable."

The RCGP will now develop four ‘roadmaps’ outlining in more detail what needs to be done to realise its vision and advocating to governments and decision-makers in England, Scotland, Wales and Northern Ireland how to deliver it.

The full report can be viewed here.

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