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  • Writer's pictureKen MacNeill

This week’s Panorama programme focussed on the shortage of GPs and alleged actions taken by one health provider to deal with that shortage. There is no doubt that there is a GP shortage and that there is a furore over that and the reported desire for the public for face-to-face appointments. There is considerable change in primary care. This change includes the increased use of technology and increased multi-disciplinary provision of care. I feel there is a real danger that this debate is being framed in such a way that it damages the prosects for achieving positive change in Primary Care.

I, for one, am grateful for the other professionals available in primary care. My three most recent (non-vaccination) engagements have been with a practice nurse, a podiatrist and a First Contact Physio. Each was exactly what the Doctor would order – literally and metaphorically – providing useful and expert care that the GP probably could not have. I could have insisted on seeing a GP but this would not have been a good use of anybody’s time.

Directing patients to the right care at the right time is an ongoing activity in the NHS. The work has begun to persuade people that they do not always need to see the Doctor. Pharmacists, physios, nurses, opticians, podiatrists and others will often be the best options for the patient and the NHS. Our work with Primary Care Networks (PCNs) in England is centred on building teams of allied health professionals that can support GP practices and the wider health economy in alleviating strain and extending the range of services that can be provided to patients. It is no great secret that PCN success across the country in so doing has been mixed. But it seems to be the approach that will best improve Primary Care and relieve the stress on a reduced GP workforce.

Getting these additional resources into play needs a number of things to be on place. The staff have to be recruited – also depends on them actually existing to be recruited. It also needs the “propaganda” battle to be won. That battle needs to be won both inside primary care and with the public. The current public debate does not help with that, irrespective of the validity of some of the concerns expressed.

I live in Scotland and there have been adverts on local radio explaining that you may be directed to other than a GP when you phone your surgery. A small initiative but an example of the activity that is vital if we are to achieve real change that takes the patients with us. It would also be remiss to not acknowledge that not all GP practices are “on board” with the suggested changes, whether it be allied health professionals or the application of digital tools.

Horses, water, sticks and carrots are all words deployed in that sphere. PCNs are being used in England as part of addressing that issue and enabling practices to access resources that would not otherwise be as easily accessible. But the argument has to be won over that being a useful way forward.


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