In the recently published General Practice Forward View, NHS England Chief Executive Simon Stevens states that, “There is arguably no more important job in modern Britain than that of the family doctor”. Few would argue that the local health system would not be able to cope without the important foundation that general practice provides.
However general practice faces significant challenges. Recent developments have proven that General Practice faces problems in recruitment, inflating workloads, low morale and satisfaction, and high stress. Tower Hamlets GP practices are coming under significant strain as they try to keep up with an ever-increasing workload of serving a deprived population using fewer resources. It is anticipated that within the next five years up to 20% of practice income could be lost, the workload will grow by a third and there will be high numbers of GPs and nurses retiring. These issues are not unique to Tower Hamlets, and are being faced right across the UK.
GPs are naturally concerned. The Local Medical Committee, NHS Tower Hamlets Clinical Commissioning Group (CCG) and the Tower Hamlets GP Care Group surveyed general practice staff in September 2015 and found that 86% of primary care workforce believe practices need to change in order to meet future demand.
In the GP Forward View Dr Arvind Madan highlighted that the workforce “cannot work any harder, so we have to find ways to work differently”. A solution lies in building skills in improving quality and efficiency within the workforce, to enable them to problem solve to achieve efficiencies themselves.
In response to the immediate challenges faced by primary care, fast, practical help is being offered to practices in Tower Hamlets that is evidencing promising results.
In October 2014, NHS Tower Hamlets CCG began a programme of work to provide immediate operational support, working with four pilot practices initially to analyse practice data and develop bespoke support plans. As part of this work, a small team spent time with the practices, immersing themselves in their day to day operations, collecting data and engaging with staff. The support was tailored to the individual requirements of each practice, and driven by the priorities identified directly by the surgeries. The aim was to help to practices to identify key areas of process that can be improved upon and support them to adopt these new ways of working. Such was the success of the initial pilots that in April 2017 the programme was rolled out to 26 practices, with an aim for full borough coverage (36 practices) by April 2018. The success in Tower Hamlets has enabled us to scale to boroughs across North East London.
There is not be a one size fits all solution – different practices face different challenges – so the type of support is based specifically on what they need. Skill mix, workflow, DNAs, financial planning – you name it, EQUIP has probably done it. The themes identified and the approach to tackle these problems are driven by the practices themselves in order to embed change. Our objective is to lead to a more resilient workforce, in a better place to manage workload.
As we know, GP practices are highly valued by local people: our surgeries are their first port of call for treatment and advice, and we are proud of our collaborative working approach, which makes supporting practices a key priority. Commissioners, providers, patients – we are all on a journey to bring joy back into general practice, for the benefit of us all.