The Policy Exchange has published a set of proposals which focus on how general practice and digital healthcare should be reformed.
Entitled ‘At Your Service: A proposal to reform general practice and enable digital healthcare at scale’, the 98-page document addresses integration, workforce, digital transformation, and scaled provision, as well as arguing for a new model of general practice.
Within the publication, Policy Exchange highlights that general practice is in need of reform – owing to ‘growing demand from an increasingly complex patient profile’, as well as a ‘stretched workforce’, the think tank says.
In a foreword, Sajid Javid, Secretary of State for Health and Social Care, commented: “There is an exciting future for primary care and we need to think deeply about how services are designed and planned – not just within general practice, but across pharmacy and dentistry too. To provide a 21st century offer to patients, we must give the front-line innovators the right tools to evolve to meet the needs of patients in the future.”
Some of the recommendations in the paper include: an overhaul of the current core GP contract; a £6 billion ‘rescue package’ to enable improvements on areas such as data collection; the ‘levelling-up’ of general practice for high-quality video consultations in areas where there are not enough doctors; and the introduction of ‘NHS Gateway’ as an entry point to primary care.
The ‘NHS Gateway’ concept focuses on a ‘smart way of booking appointments and checking symptoms’ for consumers. In the short term, the recommendation states the need for an enhancement to NHS 111 and the NHS App to transform first-contact with primary care, and encourage the ‘consumer to log conditions and to manage appointments’. In the medium term, this would enable consumers to book (or be directed) to services beyond their local GP practice and at an ICS level within their neighbourhood – including 24hr walk-in centres and community diagnostic hubs.
In addition, further recommendations include a ‘task-force’ in the NHS England Transformation Directorate to accelerate data security and to ensure digital maturity targets are met, and a Digital Health and Care Bill to be introduced to give patients more access and control over their patient data.
Dr Sean Phillips, a Research Fellow in Policy Exchange’s Health and Social Care Unit and lead author, said: “There have been growing pressures on general practice for years, but the current situation just isn’t sustainable for GPs or their patients. GPs are doing their best, but dissatisfaction is increasing among patients. We need to find ways to work smarter, rather than just demanding that stretched GPs work harder. Our package of reforms would deliver what patients value most from their GPs: quality of care, convenience, choice and continuity.
“By expanding high-quality digital healthcare, such as video consultation, we can ‘level up’ areas that have fewer GPs and enable GPs to conduct more appointments face-to-face – particularly those with complex needs. Optimising the use of the NHS App can help reduce missed GP appointments which cost the NHS £216 million every year through simple reminders and signpost patients to the place their needs are best met.”
Dr Harpeet Sood, General Practitioner in London and Non-Executive Director Health Education England, commented: “There is now a clear rationale to modernise primary care. The nature of general practice has fundamentally changed over the last decade; many of my colleagues are now seeking varied portfolio careers rather than going down the traditional partner route.
“The expectations of patients have also evolved and now diverged; some valuing speed and convenience and others, often with more complex needs, requiring time and a sense of continuity to their NHS experience.”
Read the full document and recommendations here.
