The outgoing Royal College of GPs chair Clare Gerada has been appointed to lead a project to overhaul primary care across London.
She has been named the clinical chair for primary care transformation in London, a role which is part of NHS England’s clinical networks in the city.
Dr Gerada’s term as RCGP chair, in which she has been a vociferous and prominent critic of the government’s NHS reforms, comes to an end in November.
The new role will see her chair a group leading a major attempt to improve primary care in the city. It is the first capital-wide effort of its type since Lord Darzi’s 2007 Healthcare for London report, which proposed a network of “polyclinic” health centres.
A document is due to be published by NHS England in coming weeks detailing the “case for change” of primary care in London, such as variation in performance and quality, and difficulty hiring staff. General practice in London is widely considered to face more severe problems than elsewhere in England, with poor access and inappropriate premises particularly problematic.
The new group will look at how to change services to address the problems. Other representatives will include the London Clinical Commissioning Council, which is chaired by Merton CCG chair Howard Freeman, Londonwide Local Medical Committees, and the RCGP.
Dr Gerada told HSJ her role was focused on “transforming primary care for the capital” and “moving on primary care delivery mechanisms”. It will include “addressing variability in performance”, where it is a problem, she said.
Dr Gerada said: “I’m not into revolutionary change but I am into moving things in the direction they should be going in.” Her contract is initially for a year, but the work will look at transforming services over a five year period.
She said she was not approaching the work with a “predetermined view” and there may be “different solutions in different parts of London”.
However, Dr Gerada also stepped up the debate about general practice reform, by backing the idea of creating single provider organisations combining general practice with other services, and mooting a move away from GPs working as independent contractors.
“It may be easier [to provide services] with a new organisation delivering integrated care, [in which] we are all shareholders of that not for profit cooperative,” she said.
She said this could entail moving away from general practice being predominantly provided by independent contractors, to employed, salaried GPs.
“It’s not for me to say if the independent status goes but it is for me to say, ‘Would it be better for patients if we look at a whole system approach?”
Dr Gerada works as a GP in Lambeth and is a partner in the Hurley Group, which runs around 15 practices in London.