London GP representatives oppose 'radical' primary care change

NHS England last month began a consultation on reforming primary care, and its London regional team has hired outgoing Royal College of GPs chair Clare Gerada to chair a panel considering the “transformation” of primary care in the capital.

The potential for alternative provider models to replace traditional GP practices is believed to be under consideration by NHS England, while Dr Gerada has indicated she favours GPs joining other services in single provider organisations.

A document by Londonwide Local Medical Committees, which represents GPs, which it has shared with HSJ, challenges this view.

It says: “Transformation is fast becoming an agenda for ‘fixing’ general practice, based on assumptions that GPs are failing to deliver good quality care and that faster access to general practice will result in fewer [accident and emergency] attendances and costly hospital admissions.

“This approach largely ignores the overall success story of general practice in the UK and fails to fully acknowledge the particular challenges that face London.”

It calls for “an alternative strategy” which supports “generalist clinicians to provide personalised, comprehensive continuity of care”.

The document says many GP practices need to work more closely together, through networks, federations or merger, a shift which has been supported by NHS England.

It also proposes the “protecting and maintaining [of] current GP contracts from competition, enabling partnership/merger/federation models”.

The document says: “There is a wealth of literature which advocates practices working together to reduce back office function running costs, bid for resources, support the development of high quality local services.” This will require “the right foundations need to be laid through investment and support and local determination”, it adds.

Among the document’s proposals for the future are “better access [for patients] to personal continuity of care”, and for “GPs and their practice staff [to be given] time in order to reflect, plan and learn how to improve the management of GP services”.

Londonwide LMCs chief executive Michelle Drage said: “We can deliver the outcomes people are looking for without a major radical transformation.”

She said proposals about dramatic organisational change were “way out of kilter with what GPs think would be appropriate”.