Change will be most effective when it brings together the ethos of general practice with the customer focus and responsiveness of the commercial sector, according to Paul Husselbee and Simon Bourne

General practice is facing a crisis driven by unprecedented demand, increasing expectations and inequitable funding.

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It must also face the stark reality of an ageing workforce coupled with large numbers of unfilled training places across the country – it is a career that is no longer attractive to young doctors, but which delivers the majority of healthcare.

In many places, the model of delivery has barely changed since the inception of the NHS, and it cannot be sustained.

Set framework

Pets at Home have provided a “low maintenance” framework for clinicians to deliver seven day primary care, while bringing accessible veterinary expertise to their customers in a convenient location.

Simon Bourne

Simon Bourne

The model enables clinicians to concentrate on the role they were trained for, rather than juggling this with the responsibilities of business owner, manager and administrator.

There are lessons to be learned, but general practice is as diverse as the populations that it serves and one size will not fit all.

Shared back office functions draw together limited and fragmented resources and have formed the backbone of a number of the emergent high profile partnerships and federations between GPs.

‘One size will not fit all’

The economies of scale and reduced administrative headache are attractive, but there are also additional benefits for general practice, including supporting a more rigorous and coordinated response to the growing regulatory scrutiny of the sector.

Focus on patient

However, increasing commercialisation must be balanced by remaining patient centred and holistic in the delivery of care.

Paul Husselbee

Paul Husselbee

Clinicians will be wary of association with high street brands, concerned that general practice may lose its personal touch and become simply transactional in the struggle to stay afloat.

The valuable entrepreneurial skills of many practitioners may also be better harnessed outside the constraints of a pre-existing commercial organisation.

To maintain control, GPs themselves must come together to share staff, skills and investment, rapidly forming a shared partnership to tackle the huge challenges ahead.

‘Remaining patient centred is important’

Change will be most effective when it brings together the ethos of general practice with the customer focus and responsiveness of the commercial sector and led by the clinicians who understand the nature of the work and the needs of their patients.

Dr Paul Husselbee is a GP and former chief clinical officer of Southend Clinical Commissioning Group, and Dr Simon Bourne is a consultant at GE Healthcare Finnamore. Email

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