General practice over the last few years, despite continuing to provide over 80% of all the clinical consultations in the NHS, has seen its workload hugely increased and its actual share of NHS finances reduced. Announcing the GP Forward View in 2016, Simon Stevens, chief executive since April 2014 of NHS England, said he was “openly acknowledging” the problems and acting on them.
From the child hiding an “unhelpful” school report to the smartest guys in the room at Enron playing fast and loose with the figures, the temptation to massage the data is ingrained in human nature.
We are entering a new era in which organisations work together to solve problems and deliver outcomes – rather than focusing on factory-like output figures. Population based accountable care systems promise to erode unhelpful distinctions between commissioning and provision, underpinned by new types of contract that encourage teamwork and discourage finger-pointing.
In St Austell, home to the Eden Project, new life for general practice has emerged from fairly unpromising soil.
The town’s practices began working collaboratively in 2014 but swiftly realised they had enough in common to merge in May 2015 – producing a practice serving 32,000 people. The new practice, which also absorbed patients from a failed practice that was forced to close, became a rapid test site for the primary care home (PCH) model.
Wolverhampton Total Health, a partnership of eight practices, has adopted a creative approach to its primary care home (PCH) test site.
The practices were spurred into action by a looming GP recruitment and retention crisis against the backdrop of high levels of deprivation and associated unhealthy lifestyles such as smoking and poor diet.