12 Dec 2019
Expert Insight: A GP’s perspective on the NHS crisis
With significant experience in both the public and private sector, Dr. Dan Bunstone is the lead GP of a practice in a high growth area of Warrington, serving a population of around 5000 patients. Following his recent article concerning immunisations, Dr. Bunstone explores the state of medical education and practice in the UK.
It is well recognised that a career in medicine will involve hard work and commitment, but the pay-off in terms of job satisfaction and a lifelong career are worth the sacrifice. It’s a privilege to be a GP and have the level of trust this affords. To be allowed deeply into the workings of people’s lives, as well as their hopes, fears and dreams, their insecurities and the problems they are facing, along with the triumphs they overcome and the relationships they form is an honour. It is never lost on me the amount of trust we, as GPs, are gifted - often from the first time of meeting a patient.
There is no doubt that the work within primary care is getting harder. Not only because of the increased complex conditions that primary care now deal with, but also the increasing demand for appointments. It is widely acknowledged by all of the political parties that more GPs are required nationally, with figures of 6000 being quoted and with additional support staff being brought through. The advent of the new Primary Care Networks is a significantly positive change that is being championed by NHS England, with Dr Nikki Kanani as National Medical Director leading the way. As a Clinical Director (CD) for a network myself, I can see huge amounts of enthusiasm for change, along with innovation to support delivery of the best possible patient care. Teams within the primary and secondary care community are working together in ways we have not seen before, with the clear focus of high quality patient care.
Some of the need for change is being driven by the well-publicised recruitment crisis, not only within GPs but across all sectors of healthcare. There have been various announcements over the years to commit to recruit 5000 more GPs, as well as an additional 6000 GPs. However, despite a significant increase in complex conditions - and the raw number of people needing appointments - this aspiration has not been achieved. The end result is a system stretched to capacity, supported by a committed workforce who are, themselves, stretched to capacity (and many times beyond).
Systems are changing for the better, but currently the weight of work within Primary Care makes this very difficult. Trying to improve the future whilst also dealing with what is happening now is a perennial problem. Add into the mix the already stretched teams - along with increasing need for appointments - and we find ourselves with a real challenge. But, challenge is what healthcare professionals deal with best. Opportunity exists for Primary Care Networks to deliver care in a different way - to really work collaboratively with partners, and to find innovative solutions to the problems we face. Increasingly, patient representatives are more and more involved with the strategic decision-making processes of how care is delivered.
The NHS is incredibly stretched and is grappling with how to transform the delivery of services while managing the here and now. My experience of those involved within the newly formed networks is hugely positive. There are so many committed and driven individuals working alongside each other to support the delivery of excellent and innovative services. Although there is a clear challenge ahead of us, with continued support the future looks brighter.
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