GP Partnership Review
The chief executive of Wessex LMC has been appointed chair of a major independent review of the partnership model to look into how it needs to evolve in the modern NHS.
Dr Nigel Watson, who is also a member of the BMA’s GP Committee and its former lead on commissioning, will oversee the review, which will report back to health and social care secretary Jeremy Hunt and NHS England chief executive Simon Stevens.
Dr Watson said: ‘It is a great honour to chair the review and I plan to engage widely with organisations, as well as front line clinicians and practice staff, to identify the challenges and will make a number of recommendations about how the partnership model can work in the future.’
To read the full article click here: LMC leader to chair Hunt review into 'reinvigorating' GP partnership model
GP Partnership Review – Blog
Dr Nigel Watson – GP Partner, The Arnewood Practice, New Forest and the Independent Chair of the Partnership Review of general practice.
The NHS is approaching its 70’s birthday and is viewed as one of our nation’s best loved institutions.
The vast majority of patient contacts, over 400,000,000 per year take place in general practice and over 99% of the population are registered with a practice, yet more often than not any media coverage of the NHS refers only to hospital-based care.
The GP Forward View stated “GPs are by far the largest branch of British medicine. A growing and ageing population, with complex multiple health conditions, means that personal and population-orientated primary care is central to any country’s health system. As a recent British Medical Journal headline put it – “if general practice fails, the whole NHS fails”.
The NHS has responded to the challenge of an aging population, who have more long-term conditions and complex needs by reducing the share of funding to primary care and growing the number of hospital specialists at three times the rate of GPs.
It is therefore not surprising that general practice is facing a recruitment and retention problem.
In a recent report published by the House of Lords Health Select Committee considering the long-term sustainability of the NHS concluded that “The traditional partnership model of general practice is no longer fit for purpose and should be phased out in favour of alternative models such as salaried employment”, and concluded “that the small business model of general practice was “inhibiting change” and frustrating efforts to deliver more care outside hospitals in response to increasing demand from patients and NHS staff shortages.”
Shortly after this report was published a GP magazine, Pulse, conducted a survey which showed that about 60% of GPs thought that the Partnership model of General Practice has no future and will not exist in 10 years’ time.
It has been stated on a number of occasions that the ’corner-shop model of general practice has passed its sell-by date and should be confined to history’.
When I became a GP Partner 30 years ago there were 170 applicants for the post I was lucky enough to get and all my fellow GP Trainees at the time were also looking for partnership on completion of their training. We are told now that GP Trainees no longer want partnerships and would sooner become locums or salaried GPs.
With the number of partnership vacancies running at an all-time high (in some places more than 20%) should we move from a predominantly partnership model to an employed one?
My personal view is that the partnership model has not reached the end of the road, it can still have an important role to play in the future of the NHS but we need to make it a better place to work, which will encourage more GPs to remain working in general practice, address the concerns about the unlimited personal liability and with the move to a more population based approach to healthcare ensure that general practice is truly able to play a leadership role in the local NHS.
Most practices have evolved and developed over the last 10 years, despite not having sufficient resources to evolve significantly and could not be described as a ‘corner shop’. We have witnessed a significant number of practices merging to form larger units, federations evolving to be a provider of primary care at scale and networks of practices collaborating together in a way that has not been seen over the last 70 years.
Talking to many young GPs who are completing or have recently completed their training they say that they do not want to go into partnership now but would consider this in 5 years-time.
The Secretary of State announced in February 2018 that he was going to carry out a formal review of how the partnership model needs to evolve in the modern NHS and agreed this with the Royal College of GPs and the General Practitioners Committee of the BMA, NHS England and the Department of Health and Social Care.
As a GP Partner, the Chief Executive of a large LMC, a Fellow of the RCGP (achieve by assessment not nomination) and a long-standing member of the GPC, I have been asked by the Secretary of State to be the Independent Chair of the Review. I have accepted this and see it as an honour but also a great challenge.
I have been asked to review the partnership model and make recommendations by the end of the year as to how this can be revitalised.
The review will consider, and, where appropriate, make recommendations, in the following areas:
- The challenges currently facing partnerships within the context of general practice and the wider NHS, and how the current model of service delivery meets or exacerbates these.
- The benefits and shortcomings of the partnership model for patients, partners, salaried GPs, locum GPs, broader practice staff (practice nurses etc) and the wider NHS.
- Drawing on 1) and 2), consider how best to reinvigorate the partnership model to equip it to help the transformation of general practice, benefiting patients and staff including GPs.
I will be publishing repeated blogs during this review which may be of interest to you.
Dr Nigel Watson MBBS FRCGP
GP Arnewood Practice
Chief Executive Wessex Local Medical Committees Ltd
Independent Chair, GP Partnership Review, Department of Health and Social Care