A response to 21st century health challenges
It’s not all about the money. Headline research reveals that a reduction in bureaucracy, a move away from the current box ticking culture and the opportunity to work collaboratively with health professionals across primary care would motivate GPs, practice nurses and practice managers to stay in their roles far more than an increase in their income. NHS Alliance, a leading voice for providers in primary care, undertook the straw poll[1] of members to mark the launch of its new report, which says a fundamental shift in thinking is required by all who interact with the health service: one that moves from regarding the delivery of health care towards one that relies on relationships rather than one based on as transaction and process. It describes this as a responsive and responsible service with three underlying principles:
- a responsive and responsible system;
- a responsive and responsible health professional;
- a responsive and responsible patient.
Procrastination is no longer an option according to the report, Think Big, Act Now: Creating A Community Of Care, published today. Immediate action is needed to achieve the paradigm shift required to support a growing and ageing population living with myriad complex conditions.
The paper argues the answer to a stronger, re-energised primary care workforce lies within the workforce itself and within the communities they serve; where general practice sits at the centre of a cohesive primary care team of multi-disciplinary health professionals and community leaders, and works collaboratively with colleagues in the acute sector. This, it says, has the potential to make an immediate difference on a system that is considered by many to be near breaking point.
GPs, practice and community nurses, practice managers, community pharmacists, and community eye and hearing specialists in England are under unprecedented pressure to care for a population imposing soaring demand[1] on a health service that is financially constrained and struggling to retain a demoralised workforce.
Dr Michael Dixon, chairman, NHS Alliance said: “The perfect storm of pressures facing primary care makes it likely that change will come, whether or not it is wanted. We want to see change by design rather than default: change led by those working within the service who best understand the issues they and the communities around them face. Our members tell us they are exhausted and demoralised but still passionately believe in an NHS free at the point of need and we believe there is light ahead.
“This is not all about the money. Professionals in primary care crave the time and space to spend time serving patients rather than dealing with endless paperwork and box ticking, and are open to new ways of working. But new ways of working also rely on new ways of thinking and doing. As a system, as health professionals and as the general public we need to think act responsively and responsibly to help restore the NHS and all the people associated with it to good health.
“To achieve this, we propose an incremental journey towards what we are calling A COMMUNITY OF CARE, which is based on the implementation of general practice at scale but is not all about GPs. And while it may not be about the money in terms of GP income, we do believe financial support is required to support what needs to be a rapid transformation. This must come in two forms – one, a return to at least a 10% share for primary care of overall NHS budget to reflect the fact that more than 80% care is delivered outside hospital, and two, a dedicated General Practice Development Fund to allow immediate action to be taken.
“Our vision is that this paper will mark a defining moment for general practice and primary care. A moment where we take collective responsibility for the health and wellbeing of our NHS, whether we are policy maker, care provider or care receiver. A moment where we commit to delivering and using the service thoughtfully and respectfully. A moment where we recognise that unless we are prepared to change both our thinking and our actions, we may pay the ultimate price and lose the national health service that has provided us with free care at the point of need for more than 65 years.”
The report articulates the findings of six months’ research and consultation undertaken by NHS Alliance in collaboration with its strategic and professional partners across the breadth of provision within primary care[2].
To support the three principles of responsive and responsible system, health professional and patient; and the development of a community of care with general practice and the registered patient list at its centre, the report proposes a 10 point plan and five specific and immediate steps:
- to use community and district nurses, community pharmacists, community eye care and hearing specialists to help address the current deficit of GPs and share care across different professional sectors;
- to reframe the role of Senior Community Nurse to co-ordinate health and social care for the frail and elderly living with long term conditions;
- to introduce a new role in every locality: a ‘Community Health Connector’;
- to reduce the medicalisation of issues that are often caused by social isolation or inadequate housing and introduce a new focus on social prescribing;
- to introduce a General Practice Development Fund to enable General Practice to be supported to develop at scale.
Notes to editors:
NHS Alliance is the leading independent voice for providers of health and social care outside hospital. It is the only not-for-profit membership organisation to bring together frontline clinicians and organisations of all kinds in our communities – from general practice, community pharmacy to providers of housing and emergency services.
It is driving a new integrated and collaborative, community-based model of care for an ageing population living with long term conditions, and is focused on breaking down the historic boundaries and silos that get in the way of truly progressive and innovative community-based patient care.
NHS Alliance is funded through membership, commissions by organisations like NHS England and through strategic partnerships with independent organisations, which include Capita Health and Novo Nordisk, with whom it has been exploring the potential future role of primary care in the NHS.
For further information please contact Becky Riffel, rebecca.riffel@salixandco.com, 020 8675 4779 or 07725 555030.
[1] Full results are published in Addendum 1
[1] Estimated by DH to be 4% per annum and more recently by the People’s Enquiry into London’s Health Services as more likely to be between 7% and 8%
[2] Full consultation panel, Addendum 2
