“Sweetie if you are going to be two faced, at least make one of them pretty.”
The pressures facing general practice are well known and the causes well-rehearsed – decrease in funding, negative publicity of the profession and increasing workload.
I remain optimistic that the promise of the GP Forward View will address these but have concerns about the time that support is taking to reach frontline general practice.
I have no doubt general practice is more than capable of taking on the challenges of managing patients previously managed by secondary care. We have been doing that incrementally over the last 20 years with no associated funding or resources.
Moving care closer to the patients in the community has been a mantra from the Department of Health ever since I qualified over 20 years ago and it is an indictment on that organisation that they have failed to match fund resources to achieve this. Having said that, I am positive about general practice and if we are to encourage new colleagues into the profession – nurses, doctors and management – we need to be positive about what we can achieve. For me it remains the best job in medicine.
I believe there are certain things that we can all be doing to encourage this:
1. Recognise generational change/practice reorganisation
This is the big one. New colleagues coming into general practice do not want the traditional partner model that we have grown up with. We recently asked a group of trainees their thoughts on this and only one wanted partnership in the traditional way.
I attended an enlightening lecture by Vijay Najjar at the Deanery a couple of years ago describing Generation X, Generation Y, etc. Understanding the wishes of younger colleagues is vital if we are going to attract them into the profession. They particularly value flexible working, portfolio careers and the ability to move around. These can be hard to provide in small traditional practices but working in groups, federations or single partnerships are much more achievable.
Negative publicity about general practice, much of it politically driven, is unhelpful and has damaged the profession. It is important that we reflect a positive image of general practice (though not minimising the challenges). Suffolk GP Federation has a good relationship with local radio, news and television organisations and the importance we place on it is not due to personal promotion but in getting a positive message out to the public, including other professionals. The Federation website continues to attract interest from colleagues wishing to relocate to Suffolk and we are continuing to develop it to ensure it fulfills that purpose.
3. Retaining trainees
I believe we must make greater efforts to encourage our FY2 foundation doctors in local hospitals to consider training in general practice. We need to have a presence at those training events. I have been liaising with our local hospitals to achieve this.
Similarly, we need to put more effort into our GP trainees to encourage them to stay in the local area. We have been working with the vocational training services to look at how best we can achieve that. I have been liaising with Lucy Eldon, newly appointed Associate Dean for GP Nursing at Health Education England, to look at how we can increase placements of nursing into primary care. I believe perception of primary care nursing is even worse than general practice and we need to address that urgently.
4. Medical student training
I think it is important that we value our teaching and training practices more, particularly encouraging medical students into general practice to see how fulfilling a career it can be, challenging some of the negative perceptions that they may get from hospital colleagues.
It is gratifying that in the last year the number of medical students from Cambridge going into general practice has increased from 5% to 22% and I think that does reflect the increasing importance that Cambridge has put on primary care teaching.
Paul« Previous | Next »